Individual provider Active NPI

Sherry Quan Ngo, PA-C

  • Physician Assistant
  • Jackson, MI
National Provider Identifier
1497388359
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009799 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-4800
NPI assigned
Feb 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601009799 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sngo652208@direct.hfhs.org W.A. Foote Memorial Hospital

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200424000730 MI Practitioner - Physician Assistant 2365872868 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihp Hospital Medicine - Jackson PLLCGroup PAC ID 3173961372, 50 clinicians
Iep Observation Medicine - Jackson PLLCGroup PAC ID 6800234592, 24 clinicians

Practice addresses (Care Compare)

205 N E Ave
Jackson, MI 49201-1753
Phone (248) 536-2127

Hospital & facility affiliations

  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601009799MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Physician Assistant CurrentSince Apr 1, 2020 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Wa Foote Memorial Hospital, Inc Physician Assistant Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

205 N East Ave
Fl 7
Jackson, MI 49201
Phone (517) 788-4713

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

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.

Hospital & facility affiliations 1

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": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1497388359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "SHERRY",
        "middle_name": "QUAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-19",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sngo652208@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "W.A. Foote Memorial Hospital",
            "address_1": "205 N East Ave",
            "address_2": "7th FL One Jackson Square",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.