Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jacob Clark

Individual provider Medical Physician Assistant · NPI 1013614304

Jacob Clark is a Physician Assistant in Peoria, Illinois. Graduated from Yale University School of Medicine in 2023, 3 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment.

Years since qualifying
3
Trained at
Yale University School of Medicine
In the registry since
2023
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Practice location Address checks out

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1013614304
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 8, 2023
Last updated in NPPESApril 7, 2023
Certification dateApril 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolYALE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients21
Services billed 36 a service is one billed item, such as a visit, a test or a procedure
Average patient age78

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Osf Multi-Specialty Group

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 2128 clinicians in the practice; 12 are shown here.

Other providers in Peoria