Individual provider Active NPI

Michael S. Jaskolka, DDS, MD

  • Surgery Physician
  • Wilmington, NC
National Provider Identifier
1285835355
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2014-00263 Issued in NC
Practice address
2131 S 17TH St
Wilmington, NC 28401-7407
Phone
(910) 667-9402
Fax
(877) 665-4450
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3897 WV
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7993 NC
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 24111 WV
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 201400263 NC
Surgery Physician 208600000X 2014-00263 NC Primary

Addresses

Primary practice location

2131 S 17TH St
Wilmington, NC 28401-7407

Mailing address

PO Box 936857
Atlanta, GA 31193-6857
Phone (910) 662-9331

Other practice location 1

1725 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone (910) 662-9331

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mjaskolka78772@direct.nhrmc.org Direct
Direct Messaging Address mjaskolka78772@direct.nhrmc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140425000678 NC Practitioner - Maxillofacial Surgery 0547394744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group Coastal Region LLCGroup PAC ID 2860809936, 577 clinicians

Practice addresses (Care Compare)

2131 S 17TH St
Wilmington, NC 28401-7407
Phone (910) 662-9300

Hospital & facility affiliations

  • Novant Health New Hanover Regional Medical Center Hospital, Wilmington, NC, CCN 340141
  • Novant Health Brunswick Medical Center Hospital, Supply, NC, CCN 340158

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision37
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7993NCMDProfessional Counselor
3897WVMDOral and Maxillofacial Surgery (Dentist)
201400263NCMDOral & Maxillofacial Surgery (D.M.D.)
24111WVMDOral & Maxillofacial Surgery (D.M.D.)
2014-00263NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health New Hanover Regional Medical Center LLC Surgery CurrentSince Feb 1, 2021 Accepting new patients
Novant Health Medical Group Coastal Region, LLC Current Accepting new patients
Novant Health New Hanover Regional Medical Center LLC CurrentSince Feb 1, 2021 Accepting new patients
Novant Health New Hanover Regional Medical Center LLC Current Accepting new patients
Novant Health Medical Group Coastal Region, LLC Oral and Maxillofacial Surgery CurrentSince May 1, 2021 Accepting new patients
NMG Health Services LLC CurrentSince May 1, 2021 Accepting new patients
New Hanover Medical Group PA Past Accepting new patients

Locations

2000 Brabham Ave
Jacksonville, NC 28546
Phone (910) 662-8765

800 Jefferson St
Ste 112
Whiteville, NC 28472
Phone (910) 642-8164

2221 S 17th St
Wilmington, NC 28401
Phone (910) 662-7720

109 Scotts Hill Medical Dr
Ste 204
Wilmington, NC 28411
Phone (910) 662-1960

1725 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 662-9300

5505 Currituck Dr
#200
Wilmington, NC 28403
Phone (910) 662-7720

2131 S 17th St
Wilmington, NC 28401
Phone (910) 342-3000

5301 Wrightsville Ave
Wilmington, NC 28403
Phone (910) 452-8100

Interoperability endpoints

  • Direct secure messaging: mjaskolka1247615@direct.novanthealth.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Novant Health New Hanover Rehabilitation HospitalWilmington, NC, CCN 34T141 Hospital Corporate Director Jan 1, 2024
Novant Health New Hanover Regional Medical CenterWilmington, NC, CCN 340141 Hospital Corporate Officer Jan 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1285835355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936857",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936857",
            "telephone_number": "910-662-9331",
            "fax_number": "910-662-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017407",
            "telephone_number": "910-667-9402",
            "fax_number": "877-665-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1725 New Hanover Medical Park Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035345",
            "country_code": "US",
            "telephone_number": "910-662-9331",
            "fax_number": "910-662-2403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASKOLKA",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3897",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "7993",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WV",
            "license": "24111",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "201400263",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2014-00263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjaskolka78772@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjaskolka78772@direct.nhrmc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "2131 S 17th St",
            "city": "Wilmington",
            "state": "NC",
            "country_code": "US",
            "postal_code": "284017407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.