Jacob Clark
NPI 1013614304ActiveIndividual· Physician Assistant, Medical· Peoria, IL
Physician Assistant, Medical in Peoria, Illinois, trained at Yale University School of Medicine (class of 2023). Medicare paid $1,260 for services to 21 patients in 2024.
Overview
| NPI | 1013614304 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Feb 8, 2023 |
| Last updated in NPPES | Apr 7, 2023 |
| Certified by provider | Apr 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 36 across 8 procedure codes |
| Paid by Medicare | $1,260 |
Education and affiliations
| Medical school | Yale University School of Medicine |
|---|---|
| Graduation year | 2023 |
| Medicare specialty | Physician Assistant |
Medical group
- Osf Multi-Specialty GroupMorton, IL · 2,114 clinicians
Hospital affiliation
- Saint Francis Medical CenterPeoria, IL
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 23 physician assistants in Peoria · All physician assistants in Illinois