Jesse Illich, PAS1

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Boone, NC

No coordinates on file. Search this address in Google Maps

Additional practice locations (5)

• 3200 S University Dr, Davie, FL 33328-2018 — (954) 262-1250
• 935 State Farm Rd, Boone, NC 28607-4948 — (828) 262-3886
• 1925 N Bridge St Ste 101, Elkin, NC 28621-2105 — (336) 835-7337
• 301 E Meeting St Ste 101, Morganton, NC 28655-3594 — (828) 608-0800
• 448 Cranberry St, Newland, NC 28657-8800 — (828) 737-0221

Specialties & licences

Physician Assistant (primary)	Taxonomy 363A00000X · Licence 0010-13685 (NC)
Student in an Organized Health Care Education/Training Program	Taxonomy 390200000X

Record details

NPI number	1821749383
Entity type	Individual (Type 1)
Gender	Male
Credentials	PAS1
Sole proprietor	No
NPI enumerated	January 15, 2022
Last updated in NPPES	December 14, 2023
Certification date	December 14, 2023

Medicare enrollment

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

Medicare specialty	PHYSICIAN ASSISTANT
Medical school	OTHER
Graduated	2023 (3 years in practice)
Group practice	High Country Community Health — 35 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount