Active NPI
Michael S. Jaskolka, DDS, MD
- Surgery Physician
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 2014-00263
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 LLC
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
- Novant Health Brunswick Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 37 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7993 | NC | MD | Professional Counselor |
| 3897 | WV | MD | Oral and Maxillofacial Surgery (Dentist) |
| 201400263 | NC | MD | Oral & Maxillofacial Surgery (D.M.D.) |
| 24111 | WV | MD | Oral & Maxillofacial Surgery (D.M.D.) |
| 2014-00263 | NC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health New Hanover Regional Medical Center LLC | Surgery | Current | Accepting new patients |
| Novant Health Medical Group Coastal Region, LLC | Current | Accepting new patients | |
| Novant Health New Hanover Regional Medical Center LLC | Current | 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 | Current | Accepting new patients |
| NMG Health Services LLC | Current | 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
- 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.
| Facility | Type | Role | Since |
|---|---|---|---|
| Novant Health New Hanover Rehabilitation Hospital | Hospital | Corporate Director | Jan 1, 2024 |
| Novant Health New Hanover Regional Medical Center | 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.
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
Corporate Officer
-
- Rehabilitation Hospital
- Wilmington, NC
- NPI 1508453754
Corporate Director
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.
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1649865791
NC
-
- Certified Registered Nurse Anesthetist
- Wilmington, NC
- NPI 1750978839
NC
-
- Cardiovascular Disease Physician
- Wilmington, NC
- NPI 1982280285
-
- Maternal & Fetal Medicine Physician
- Bolivia, NC
- NPI 1558242495
-
- Internal Medicine Physician
- Wilmington, NC
- NPI 1841877263
Oral and Maxillofacial Surgery
-
- Internal Medicine Physician
- Wilmington, NC
- NPI 1396332482
Surgery
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Wilmington, NC
- NPI 1932958584
-
- Family Medicine Physician
- Wilmington, NC
- NPI 1992751374
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wilmington, NC
- NPI 1376139139
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.