Individual provider Active NPI

Jacob Downey, PA

  • Physician Assistant
  • Dearborn Heights, MI
National Provider Identifier
1083484919
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
3902 Monroe St
Dearborn Heights, MI 48125-2545
Phone
(313) 562-1985
Fax
(313) 562-0380
NPI assigned
Jan 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

3902 Monroe St
Dearborn Heights, MI 48125-2545

Mailing address

3902 Monroe St
Dearborn Heights, MI 48125-2545
Phone (313) 562-1985

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-4000

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
I20250502002322 MI Practitioner - Physician Assistant 0345767356 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Care Well Medical Center PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jacob.downey.1@23214.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1083484919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 MONROE ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252545",
            "telephone_number": "313-562-1985",
            "fax_number": "313-562-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 MONROE ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252545",
            "telephone_number": "313-562-1985",
            "fax_number": "313-562-0380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "43614",
            "country_code": "US",
            "telephone_number": "419-383-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOWNEY",
        "first_name": "JACOB",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.