Individual provider Active NPI

Jessica Elizabeth Minchella, PA-C

  • Medical Physician Assistant
  • Lenox, MI
National Provider Identifier
1194231597
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601011787 Issued in MI
Practice address
36555 26 Mile Rd
Lenox, MI 48048-3185
Phone
(947) 523-4000
NPI assigned
Dec 20, 2017
Last updated
May 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601011787 MI Primary

Addresses

Primary practice location

36555 26 Mile Rd
Lenox, MI 48048-3185

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

31290 Groesbeck Hwy
Fraser, MI 48026-2517
Phone (586) 944-2272

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jminchella1247089@epic00.shdirect.org

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
I20260331002682 MI Practitioner - Physician Assistant 3375028087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26901 Beaumont Blvd
Southfield, MI 48033-3849

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601011787MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medpointe Urgent Care Walk in Clinic PC PastSince Jun 11, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jminchella1247089@epic00.shdirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1194231597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36555 26 MILE RD",
            "city": "LENOX",
            "state": "MI",
            "postal_code": "480483185",
            "telephone_number": "947-523-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31290 Groesbeck Hwy",
            "address_purpose": "LOCATION",
            "city": "Fraser",
            "state": "MI",
            "postal_code": "480262517",
            "country_code": "US",
            "telephone_number": "586-944-2272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINCHELLA",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601011787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jminchella1247089@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "36555 26 Mile Rd",
            "city": "Lenox",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480483185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lenox, MI

Sources for this page

Verify at the official NPI Registry.