Jacob Mastropaolo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601010190 Issued in MI

Practice address

27275 Haggerty Rd Ste 500
Novi, MI 48377-3635

Phone

(248) 741-6909

NPI assigned

Oct 22, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/10301/brand/1/csg/1/fhir/r4

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.

• Henry Ford Health Macomb-Oakland Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Macomb Oakland Hospital

  • Nurse Practitioner
  • Warren, MI
  • NPI 1578696092
  Medicare reassignment
• Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
  • NPI 1578891750

  Physician Assistant

  NPD
• Envision Medical Group PLLC

  • Family Medicine Physician
  • Northville, MI
  • NPI 1821391848
  NPD
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• University Allergy & Asthma Center PLLC

  • Allergy & Immunology Physician
  • Southfield, MI
  • NPI 1225300155
  NPD (past)

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1356940175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27420",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049152026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27275 HAGGERTY RD STE 500",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773635",
            "telephone_number": "248-741-6909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 N Pontiac Trl",
            "address_purpose": "LOCATION",
            "city": "Walled Lake",
            "state": "MI",
            "postal_code": "483903448",
            "country_code": "US",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASTROPAOLO",
        "first_name": "JACOB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-22",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeannie Mae Massey, LLBSW
• Kimberly Masso
• Kerrie Massolin
• Deanna Susan Master, MD
• David Leron Mastin Sr.
• Taleah Mata-Morrow
• Jasmine Mata
• Alexa Matanguihan
• Valerie Matanguihan
• Cecilia Matar

• Physician Assistant in Novi, MI
• Providers in Novi, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.

Verify at the official NPI Registry.