Jacob Thomas Johengen, DO
Individual provider Active NPI Family Medicine Physician · Milan, MI
NPI 1154945558 · NPPES record last updated Jun 23, 2023
Key facts
- NPI
- 1154945558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5151014543 (MI)
- Practice address
- 870 E Arkona Rd Ste 100
Milan, MI 48160-9770 - Phone
- (734) 439-2429
- Fax
- (734) 439-0200
- NPI assigned
- Jun 1, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Osteopathic Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Iha Health Services Corporation
Practice addresses (Care Compare)
4990 W Clark Rd
Ypsilanti, MI 48197-1149
Hospital & facility affiliations
- Shared Services Home Health Care
- Trinity Health Ann Arbor Hospital
- Promedica Monroe Regional Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230707001400 | MI | Practitioner - Family Practice | 2365863016 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iha Health Services Corporation | Family Medicine | Current |
Accepting new patients |
| Iha Health Service Corporation | Current |
Accepting new patients | |
| Iha Health Services Corporation | Current | Accepting new patients |
Locations
24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400
128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677
870 E Arkona Rd
Ste 100
Milan, MI 48160
Phone (734) 439-2429
870 E Arkona Rd
Milan, MI 48160
Phone (734) 439-2420
4990 W Clark Rd
Ste 200
Ypsilanti, MI 48197
Phone (734) 572-7500
Interoperability endpoints
- jjohengen2752433@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5151014543 | MI | Yes |
Addresses
Primary practice location
870 E Arkona Rd Ste 100
Milan, MI 48160-9770
Mailing address
24 Frank Lloyd Wright Dr # J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766
Other providers in Milan, MI
- Iha Health Services Corporation
- Chijioke Ikeogu
- Jane Elizabeth Imo
- Gary Jasbeck
- Jay Eichler, DPM, PC
- Amanda S Kaiser
- Bridget E Kasmenn
- Edward Key Kim
- David Klerkx
- Kroger Co of Michigan
All providers in Milan, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.