Nicole Jack, PA-C
NPI 1083104137 · Physician Assistant · Pontiac, IL
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Nicole Jack, PA-C is a Physician Assistant provider in Pontiac, IL (NPI 1083104137).
Provider details
- NPI number
- 1083104137
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 085006579 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
8 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
125 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 68 | $103 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 31 | $13 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 26 | $72 |
Typical Medicare-allowed amounts for these services range $13–$103 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 7 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Amoxicillin/Potassium Clavbrand: Amoxicillin-Clavulanate Potass | 17 | 17 |
| Azithromycin | 16 | 15 |
| Prednisone | 14 | 12 |
| Atorvastatin Calcium | 13 | — |
| Cephalexin | 13 | 11 |
| Quetiapine Fumarate | 13 | — |
| Nystatin | 11 | — |
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-05-15
- Last updated
- 2018-06-18
Frequently asked questions
- What is Nicole Jack's NPI number?
- Nicole Jack's National Provider Identifier (NPI) is 1083104137, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Nicole Jack's specialty?
- Nicole Jack is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Nicole Jack located?
- Nicole Jack's practice location on file with NPPES is 2500 W Reynolds St, Pontiac, IL 61764.
- What is Nicole Jack's phone number?
- The practice phone number listed in the NPPES registry for Nicole Jack is (815) 844-5343.
- Does Nicole Jack accept Medicare?
- Nicole Jack is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Nicole Jack's NPI active?
- Yes — Nicole Jack's NPI (1083104137) is active in the NPPES registry as of the last update on 2018-06-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.