Individual provider Active NPI

Jennifer A Meitzner, N.P.-C

  • Nurse Practitioner
  • Warren, MI
National Provider Identifier
1154515203
Registry record updated Aug 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704239164 Issued in MI
Practice address
13450 E 12 Mile Rd
Warren, MI 48088-3671
Phone
(586) 759-5525
Fax
(586) 759-4765
NPI assigned
Aug 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704239164 MI Primary

Addresses

Primary practice location

13450 E 12 Mile Rd
Warren, MI 48088-3671

Mailing address

13450 E 12 Mile Rd
Warren, MI 48088-3671
Phone (586) 759-5525

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
I20071019000635 MI Practitioner - Nurse Practitioner 0941396006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Michigan PCGroup PAC ID 0941511224, 40 clinicians

Practice addresses (Care Compare)

13450 E 12 Mile Rd
Warren, MI 48088-3671
Phone (586) 759-5525

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
81.43
Promoting interoperability
82
Improvement activities
40
Cost
80.91

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704239164MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of Michigan PC CurrentSince May 4, 2015 Accepting new patients

Locations

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

13717 23 Mile Rd
Shelby Township, MI 48315
Phone (586) 580-9417

13467 23 Mile Rd
Shelby Township, MI 48315
Phone (248) 267-5040

13450 E 12 Mile Rd
Warren, MI 48088
Phone (586) 759-5525

Organizations & group practices 1

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": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1154515203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13450 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883671",
            "telephone_number": "586-759-5525",
            "fax_number": "586-759-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13450 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480883671",
            "telephone_number": "586-759-5525",
            "fax_number": "586-759-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEITZNER",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "credential": "N.P.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704239164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.