Individual provider Active NPI

Jason Alexander Papaconstandinou, MD

  • Psychiatry Physician
  • Coldwater, MI
National Provider Identifier
1518525641
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301507568 Issued in MI
Practice address
200 Vista Dr
Coldwater, MI 49036-1776
Phone
(517) 278-2129
NPI assigned
Jun 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301507568 MI Primary

Addresses

Primary practice location

200 Vista Dr
Coldwater, MI 49036-1776

Mailing address

200 Vista Dr
Coldwater, MI 49036-1776
Phone (517) 278-2129

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230312000015 MI Practitioner - Psychiatry 6800260993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Branch County Community Mental Health AuthorityGroup PAC ID 4789612714, 12 clinicians

Practice addresses (Care Compare)

200 Vista Dr
Coldwater, MI 49036-1776
Phone (517) 278-2129

Hospital & facility affiliations

  • Insight Hospital and Medical Center Coldwater Hospital, Coldwater, MI, CCN 230022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Branch County Community Mental Health Authority CurrentSince Dec 6, 2022 Accepting new patients
Partners in Wellness Past Accepting new patients
Detroit Wayne County Health Authority PastSince Jul 6, 2020 Accepting new patients

Locations

200 Vista Dr
Coldwater, MI 49036
Phone (517) 278-2129

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

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.

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1518525641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VISTA DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361776",
            "telephone_number": "517-278-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VISTA DR",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490361776",
            "telephone_number": "517-278-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPACONSTANDINOU",
        "first_name": "JASON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301507568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

Verify at the official NPI Registry.