JAN MIRIAM JACOB-WICKLAND (PA-C) – Physician Assistant, NPI 1508980541

JAN MIRIAM JACOB-WICKLAND (PA-C) is a healthcare provider. based in Saint louis, Missouri. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 119559 (MO). The NPI Number for JAN MIRIAM JACOB-WICKLAND (PA-C) is 1508980541

Main info

Female
40 Years Of Experience
Accepts Medicare Assignment
Name
JAN MIRIAM JACOB-WICKLAND (PA-C)
NPI
1508980541
Phone
(314) 454-8134
Address
1 Barnes Jewish Hospital Plz
Enumeration Date
16 March 2007
Last Update Date
20 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3142514687
Graduation Year
1986 (40 years ago)
PAC ID
6002155645
Group Practice PAC ID
6204720667
Professional Enrollment ID
I20190226003528
Address ID
MO631418221SA615XXRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,854 PHYSICIAN ASSISTANT in MO

Provider Addresses for JAN MIRIAM JACOB-WICKLAND (PA-C)

  • 1 Barnes Jewish Hospital Plz

    Saint Louis, MO 631101003

    Phone: (314) 454-8134

    Type: Location

  • 1054 BIG BEND STATION DR

    MANCHESTER, MO 630881429

    Phone: (636) 861-1102

    Type: Mailing

  • 615 S NEW BALLAS RD DEPT OF

    SAINT LOUIS, MO 631418221

    Phone: (314) 251-6000

    Fax: (636) 386-7679

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-02-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190226003528IPhysician AssistantMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes216214$0
99203New patient office or other outpatient visit, 30-44 minutes158158$0
View full utilization report →

Insurance plans in this area (ZIP 63110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6204720667View full group profile
NameSpecialtyState
Anesthesiology AssistantMO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
A N E S T H E S I O L O G YMO
A N E S T H E S I O L O G YMO
A N E S T H E S I O L O G YMO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO
Certified Registered Nurse Anesthetist (Crna)MO

Reviews

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Frequently asked questions

What is JAN MIRIAM JACOB-WICKLAND (PA-C)'s NPI number?
JAN MIRIAM JACOB-WICKLAND (PA-C)'s NPI is 1508980541 — the number used across U.S. healthcare to identify this provider.
Is JAN MIRIAM JACOB-WICKLAND (PA-C) shown as active in public data?
Registry records indicate JAN MIRIAM JACOB-WICKLAND (PA-C) maintains an active NPI.
What expertise is attributed to JAN MIRIAM JACOB-WICKLAND (PA-C)?
JAN MIRIAM JACOB-WICKLAND (PA-C)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
Is JAN MIRIAM JACOB-WICKLAND (PA-C) associated with Saint Louis?
Public fields place JAN MIRIAM JACOB-WICKLAND (PA-C) around Saint Louis, Missouri. Always confirm the exact site before visiting.
Can I trust this NPI listing for JAN MIRIAM JACOB-WICKLAND (PA-C)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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