NPIMap

Individual provider Active NPI

Jessica Marie Gould, PA-C

  • Physician Assistant
  • Grosse Pointe, MI
National Provider Identifier
1053076109
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601010808 Issued in MI
Practice address
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone
(313) 473-6899
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 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 5601010808 MI Primary

Addresses

Primary practice location

468 Cadieux Rd
Grosse Pointe, MI 48230-1507

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849
Phone (947) 522-1848

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgould1760294@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211109000689 MI Practitioner - Physician Assistant 5092104364 Reassigns benefits to 14 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
85.06
Promoting interoperability
100
Improvement activities
40
Cost
77.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Urgent Care PC CurrentSince Nov 1, 2021 Accepting new patients

Locations

23234 Ecorse Rd
Taylor, MI 48180
Phone (313) 292-8400

Interoperability endpoints

  • Direct secure messaging: jgould1760294@direct.beaumont.edu
  • Direct secure messaging: jgould1235673@epic00.shdirect.org

Organizations & group practices 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1053076109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 CADIEUX RD",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301507",
            "telephone_number": "313-473-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULD",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgould1760294@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "468 Cadieux Rd",
            "city": "Grosse Pointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482301507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.