Individual provider Active NPI

Justin M. Panzica, PA

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1336540749
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6861175 Issued in ID
Practice address
44201 Dequindre Rd
Troy, MI 48085-1117
Phone
(248) 964-4866
NPI assigned
Sep 5, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601007114 MI
Physician Assistant 363A00000X PA17836 TX
Physician Assistant 363A00000X 6861175 ID Primary

Addresses

Primary practice location

44201 Dequindre Rd
Troy, MI 48085-1117

Mailing address

5605 N Macarthur Blvd
Irving, TX 75038-2617

Other practice location 1

5605 N MacArthur Blvd Ste 740
Irving, TX 75038
Phone (214) 960-5681 ext. 75

Other practice location 2

709 N Lincoln Ave
Jerome, ID 83338-1851
Phone (208) 814-9500

Other practice location 3

1140 N State St
Saint Ignace, MI 49781-1048
Phone (303) 390-1940

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpanzica25224@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TX, ID, IL, FL, AZ, TN, WI, WA9 enrollments
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 9

Enrollment IDStateProvider typePAC IDDetails
I20140924001611 MI Practitioner - Physician Assistant 9436378403 Reassigns benefits to 6 organizations
I20240424001273 TX Practitioner - Physician Assistant 9436378403 Reassigns benefits to 5 organizations
I20250218001667 ID Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization
I20250417003211 IL Practitioner - Physician Assistant 9436378403 Reassigns benefits to 2 organizations
I20250514001634 FL Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization
I20250821001342 AZ Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization
I20260304002607 TN Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization
I20260306000206 WI Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization
I20260306003139 WA Practitioner - Physician Assistant 9436378403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Post Acute Specialists LLCGroup PAC ID 1951676568, 180 clinicians
Rural Physicians Group-Pannu PLLCGroup PAC ID 0345467486, 141 clinicians
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians
Carrus Care Physicians Group IncGroup PAC ID 3476898040, 17 clinicians

Practice addresses (Care Compare)

107 E Beckert Rd
New London, WI 54961-2509
Phone (920) 982-5354

1140 N State St
Saint Ignace, MI 49781-1048
Phone (906) 643-7999

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

2700 W Honadel Blvd
Oak Creek, WI 53154-2650
Phone (414) 435-2005

3601 N Calais St
Baylor Scott and White Surgical Hosp
Sherman, TX 75090-1785
Phone (903) 870-2994

520 N 4TH Ave
Pasco, WA 99301-5257
Phone (214) 960-5681

W4266 County Rd X
Owen, WI 54460-3301
Phone (715) 229-2172

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10369AZMDPharmacist
6861175IDMDPhysician Assistant
5601007114MIMDPhysician Assistant
PA17836TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical Physician Assistant CurrentSince Apr 1, 2024 Accepting new patients
Post Acute Specialists, LLC CurrentSince Jan 29, 2026 Accepting new patients
Texas Post Acute Specialists, PA CurrentSince Jan 29, 2026 Accepting new patients
Sound Inpatient Physicians-Michigan, PLLC Physician Assistant CurrentSince Jun 11, 2019 Accepting new patients
Rural Physicians Group-Pannu PLLC CurrentSince Feb 7, 2025 Accepting new patients
Mi Post Acute Specialists PC CurrentSince Jan 29, 2026 Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients
Mackinac Straits Health System Inc Past Accepting new patients

Locations

6051 E 34th St
Yuma, AZ 85365
Phone (928) 247-8300

5575 Dtc Pkwy
Ste 225
Greenwood Village, CO 80111

709 N Lincoln Ave
Jerome, ID 83338
Phone (208) 324-4301

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

471 W Terra Cotta Ave
Crystal Lake, IL 60014
Phone (815) 455-0550

818 Riverside Ave
Adrian, MI 49221
Phone (517) 263-0711

400 Hobart St
Cadillac, MI 49601
Phone (231) 876-7200

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

1721 S Stephenson Ave
Iron Mountain, MI 49801
Phone (906) 776-5415

707 Armstrong Rd
Lansing, MI 48911
Phone (517) 393-5680

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

1140 N State St
Saint Ignace, MI 49781
Phone (906) 643-0466

805 W Cedar St
Standish, MI 48658
Phone (989) 846-3500

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

3737 N Garland Ave
Garland, TX 75040
Phone (214) 315-6310

2712 Hurstview Dr
Hurst, TX 76054
Phone (817) 281-6407

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

Interoperability endpoints

  • Direct secure messaging: jpanzica25224@direct.beaumont.edu

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1336540749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-4866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5605 N MacArthur Blvd Ste 740",
            "address_purpose": "LOCATION",
            "city": "Irving",
            "state": "TX",
            "postal_code": "75038",
            "country_code": "US",
            "telephone_number": "214-960-5681 x75",
            "fax_number": "214-960-5681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "709 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Jerome",
            "state": "ID",
            "postal_code": "833381851",
            "country_code": "US",
            "telephone_number": "208-814-9500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1140 N State St",
            "address_purpose": "LOCATION",
            "city": "Saint Ignace",
            "state": "MI",
            "postal_code": "497811048",
            "country_code": "US",
            "telephone_number": "303-390-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANZICA",
        "first_name": "JUSTIN",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-05",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007114",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17836",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "6861175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpanzica25224@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.