Samuel T Korican, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601012137 Issued in MI

Practice address

744 W Michigan Ave Ste 201
Jackson, MI 49201-1900

Phone

(517) 205-7618

NPI assigned

Oct 10, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092
• Hillsdale Hospital Hospital, Hillsdale, MI, CCN 230037

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skorican1016209@direct.hfhs.org

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.

• Wa Foote Memorial Hospital, Inc

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MI
  • NPI 1790222651
  NPD

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

• Hillsdale Community Health Center

  • General Acute Care Hospital
  • Hillsdale, MI
  • NPI 1730115940
  Care Compare affiliation
• W.a. Foote Memorial Hospital

  • General Acute Care Hospital
  • Jackson, MI
  • NPI 1053403402
  Care Compare affiliation

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1114708609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE STE 201",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011900",
            "telephone_number": "517-205-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE STE 201",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011900",
            "telephone_number": "517-205-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORICAN",
        "first_name": "SAMUEL",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-10",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenay B Kolito
• Aram Koltookian, DO
• Angela D Kono, LPC
• Patricia Lynn Koprivica, CRNA
• Laura Marie Kopulos, CRNA
• Walter Gregory Korytowsky, M.D.
• Aron O'Brien Koszegi, M.A., L.L.P.
• Risten Koszegi
• Lily Kovach
• Ashley Rose Kowynia

• Physician Assistant in Jackson, MI
• Providers in Jackson, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.