Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jan Miriam Jacob-Wickland, PA-C

Individual provider Physician Assistant · NPI 1508980541

Jan Miriam Jacob-Wickland, PA-C is a Physician Assistant in Saint Louis, Missouri. Qualified in 1986, 40 years ago. Practices with Western Anesthesiology Associates Inc, a 254-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
40
Licensed in
MO
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

615 S New Ballas Rd Dept OF
Saint Louis, MO 63141-8221
Phone: (314) 251-6000
Fax: (636) 386-7679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 — (314) 454-8134

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 119559 (MO)

Record details

NPI number1508980541
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 16, 2007
Last updated in NPPESFebruary 20, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1986 (40 years in practice)
Group practice Western Anesthesiology Associates Inc — 254 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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