Justin Patrick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011860 Issued in MI

Practice address

24725 W 12 Mile Rd Ste 260
Southfield, MI 48034-8310

Phone

(248) 382-8052

NPI assigned

Jul 5, 2023

Sex

Male

Sole proprietor

Yes

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, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Hatahet Center PLLCGroup PAC ID 5193183986, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ICGHCA/Endpoint/ICGHCA
• Direct secure messaging: justin.patrick.1@31078.direct.athenahealth.com
• Direct secure messaging: jpatrick1144067@direct.hfhs.org

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.

• Hatahet Center PLLC

  • Internal Medicine Physician
  • Waterford, MI
  • NPI 1629762497
  Medicare reassignment Care Compare group
• Alpha Urgent Care PLLC

  • Health Service Clinic/Center
  • Rochester Hills, MI
  • NPI 1326630716
  Medicare reassignment
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment
• Observation Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1497920524
  Medicare reassignment
• Alpha Urgent Care PLLC

  • Health Service Clinic/Center
  • Rochester Hills, MI
  • NPI 1073304416
  NPD (past)
• Medical Practice Management Consulting PLLC

  • Internal Medicine Physician
  • Waterford, MI
  • NPI 1275731788
  NPD (past)

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

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1366120982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PARK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24725 W 12 MILE RD STE 260",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348310",
            "telephone_number": "248-382-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vijay Motilal Patel, PHARMD.
• Patient Care Home Health Specialist, Inc
• Patient's Choice Home Health Care, LLC (Med Plus HOme Health Care. LLC)
• Patients Health Medical Plan, Inc
• Patrice L. Harold, M.D.,PLC
• Emilie Anne Patsalis, DPT
• Angela Patten, RD, CSG, CDCES
• Shereen Michelle Patten, AGACNP
• Megan Patterson, B.A
• Terri Patton

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.