Active NPI
Jerrica Atiyeh, PA-C
- Medical Physician Assistant
- Pontiac, MI
National Provider Identifier
1467067975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 5601010168
- Practice address
- 44200 Woodward Ave Ste 101
Pontiac, MI 48341-5046 - Phone
- (248) 212-0678
- Fax
- (248) 212-0790
- NPI assigned
- Sep 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 5601010168 | MI | Primary |
Addresses
Primary practice location
44200 Woodward Ave Ste 101
Pontiac, MI 48341-5046
Mailing address
44200 Woodward Ave Ste 101
Pontiac, MI 48341-5046
Phone (248) 212-0678
Other practice location 1
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8804
Other names 1
- Jerrica Clemens
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jatiyeh3210101@epic00.corewelldirect.org |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210217000674 | MI | Practitioner - Physician Assistant | 4688089063 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Detroit Mercy School of Dentistry, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Beaumont Medical Group Hospital Based Services
Practice addresses (Care Compare)
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8196
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187
44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111
Hospital & facility affiliations
- Beaumont Hospital - Farmington Hills
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601010168 | MI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A3 Medical | Past | Accepting new patients |
Interoperability endpoints
- jatiyeh3210101@epic00.corewelldirect.org
Organizations & group practices 3
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.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
MI
-
- Infectious Disease Physician
- Pontiac, MI
- NPI 1699934554
MI
-
- Internal Medicine Physician
- Bloomfield, MI
- NPI 1366798373
Hospital & facility affiliations 8
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": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755129600000",
"number": "1467067975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44200 WOODWARD AVE STE 101",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415046",
"telephone_number": "248-212-0678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44200 WOODWARD AVE STE 101",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415046",
"telephone_number": "248-212-0678",
"fax_number": "248-212-0790"
}
],
"practiceLocations": [
{
"address_1": "28050 Grand River Ave",
"address_purpose": "LOCATION",
"city": "Farmington Hills",
"state": "MI",
"postal_code": "483365919",
"country_code": "US",
"telephone_number": "947-521-8804",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ATIYEH",
"first_name": "JERRICA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-11",
"last_updated": "2025-08-14",
"certification_date": "2025-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MI",
"license": "5601010168",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jatiyeh3210101@epic00.corewelldirect.org",
"affiliation": "N",
"address_1": "28050 Grand River Ave",
"city": "Farmington Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483365919",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JERRICA",
"last_name": "CLEMENS",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.