Jaclyn Riley

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704347010 Issued in MI

Practice address

2050 N Haggerty Rd Ste 200
Canton, MI 48187-3796

Phone

(313) 550-3353

NPI assigned

Jan 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn Onstwedder Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
• Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jonstwedder1249557@epic00.shdirect.org
• Direct secure messaging: jonstwedder5012466@direct.beaumont.edu

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• Oakwood Ambulatory LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1003829441
  NPD (past)

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

• Oakwood Healthcare Inc

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Wayne, MI
  • NPI 1295785285
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1610150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1063000545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 BEACONSFIELD AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301346",
            "telephone_number": "313-550-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 N HAGGERTY RD STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873796",
            "telephone_number": "313-550-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-09",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704347010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonstwedder5012466@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "2050 N Haggerty Rd Ste 200",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481873796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "ONSTWEDDER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beverly Richardson, LPN
• Mark Donald Richter, M.D.
• Thomas J Ridella, MD
• Right Choice Care LLC
• Rex Bryan Rigor, PT, DPT,CLT
• Rite Aid of Michigan Inc
• Rite Choice Home Health Care, LLC
• Abraham Rizqalla
• Bryan Christopher Roach
• Margaret Elizabeth Roach

• Nurse Practitioner in Canton, MI
• Providers in Canton, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.