Individual provider Active NPI

Jessica Lee Mowbray

  • Physician Assistant
  • Standish, MI
National Provider Identifier
1043861263
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
805 W Cedar St
Standish, MI 48658-9526
Phone
(989) 846-4888
Fax
(989) 846-3538
NPI assigned
Sep 28, 2019
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

805 W Cedar St
Standish, MI 48658-9526

Mailing address

805 W Cedar St
Standish, MI 48658-9526
Phone (989) 846-4888

Other practice location 1

4040 N Euclid Ave # B50
Bay City, MI 48706-2484
Phone (989) 671-9153

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jessicaruff@smomsjhs.allscriptsdirect.net
Direct Messaging Address jessicaruff@smomsjhs.allscriptsdirect.net

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
I20200512001642 MI Practitioner - Physician Assistant 7517398340 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center AlmaGroup PAC ID 3375451404, 140 clinicians

Practice addresses (Care Compare)

121 N Pine River St
Ithaca, MI 48847-1039
Phone (989) 875-5111

300 E Warwick Dr
Alma, MI 48801-1014
Phone (989) 466-7050

314 E Warwick Dr
Suite 3
Alma, MI 48801-1014
Phone (989) 331-7940

320 E Warwick Dr
Alma, MI 48801-1014
Phone (989) 466-7020

330 E Warwick Dr
Alma, MI 48801-1014
Phone (989) 629-8140

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Standish CurrentSince Aug 1, 2022 Accepting new patients
Mymichigan Medical Center Alma CurrentSince Jun 24, 2024 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Dec 24, 2021 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Jun 1, 2020 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Jun 1, 2020 Accepting new patients
Mymichigan Medical Center Saginaw CurrentSince Jun 1, 2020 Accepting new patients
Mymichigan Medical Center Alma Past Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients
Mymichigan Medical Center Saginaw Past Accepting new patients

Locations

300 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0104

330 E Warwick Dr
Alma, MI 48801
Phone (989) 466-3330

4040 N Euclid Ave
Bay City, MI 48706
Phone (989) 671-9153

4040 N Euclid Ave
#B50
Bay City, MI 48706
Phone (989) 671-9153

4040 N Euclid Ave
Ste B
Bay City, MI 48706
Phone (989) 671-9153

9900 Birch Run Rd
Ste D
Birch Run, MI 48415
Phone (989) 624-1575

121 N Pine River St
Ithaca, MI 48847
Phone (989) 875-0662

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

805 W Cedar St
Standish, MI 48658
Phone (989) 846-3500

1212 W Saginaw Rd
Vassar, MI 48768
Phone (989) 823-5020

Interoperability endpoints

  • Direct secure messaging: jmowbray127733@mymichiganhealth.midirect.net

Organizations & group practices 12

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1569628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1043861263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W CEDAR ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589526",
            "telephone_number": "989-846-4888",
            "fax_number": "989-846-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W CEDAR ST",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589526",
            "telephone_number": "989-846-4888",
            "fax_number": "989-846-3538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4040 N Euclid Ave # B50",
            "address_purpose": "LOCATION",
            "city": "Bay City",
            "state": "MI",
            "postal_code": "487062484",
            "country_code": "US",
            "telephone_number": "989-671-9153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOWBRAY",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-28",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessicaruff@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "4040 N Euclid Ave # B50",
            "city": "Bay City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "487062484",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessicaruff@smomsjhs.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "805 W Cedar St",
            "city": "Standish",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486589526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Standish, MI

Sources for this page

Verify at the official NPI Registry.