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

Individual provider Physician Assistant · NPI 1104179795

Jason Roach, PA-C is a Physician Assistant in Peoria, Illinois. Qualified in 2012, 14 years ago. Practices with Carle Eureka Hospital, an 11-clinician group. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2012
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

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone: (309) 655-2036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085.004474 (IL)

Record details

NPI number1104179795
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 19, 2012
Last updated in NPPESOctober 19, 2012
Mailing address280 E Greenwood St, Morton, IL 61550-2572

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Carle Eureka Hospital — 11 clinicians
Accepts Medicare assignment Not indicated
Practice locations4 on file with Medicare

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