Individual provider Active NPI

Erin Marie Jakovac, FNP

  • Nurse Practitioner
  • Wyandotte, MI
National Provider Identifier
1003574914
Registry record updated Dec 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704304551 Issued in MI
Practice address
2124 Davis St
Wyandotte, MI 48192-3539
Phone
(734) 308-3814
NPI assigned
Dec 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704304551 MI Primary

Addresses

Primary practice location

2124 Davis St
Wyandotte, MI 48192-3539

Mailing address

2124 Davis St
Wyandotte, MI 48192-3539
Phone (734) 308-3814

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212001591 MI Practitioner - Nurse Practitioner 7012386162 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mohammad Saleh MD PC CurrentSince Sep 8, 2022 Accepting new patients
Alzohaili Medical Consultants MD PC CurrentSince Mar 27, 2024 Accepting new patients
Ally Endocrinology PLLC PastSince Sep 1, 2021 Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

1637 Monroe St
Dearborn, MI 48124
Phone (313) 278-1700

5250 Auto Club Dr
Ste 200
Dearborn, MI 48126
Phone (313) 203-5300

5220 Oakman Blvd
Dearborn, MI 48126
Phone (313) 203-5300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24740/brand/1/csg/1/fhir/r4
  • Direct secure messaging: erin.jakovac.1@24740.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1003574914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 DAVIS ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923539",
            "telephone_number": "734-308-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 DAVIS ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481923539",
            "telephone_number": "734-308-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOVAC",
        "first_name": "ERIN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704304551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.