Individual provider Active NPI

Jonathan Smiley

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1558643510
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006189 Issued in MI
Practice address
22101 Moross Rd
Detroit, MI 48236-2148
Phone
(313) 343-4000
NPI assigned
Sep 15, 2011
Last updated
Sep 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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 5601006189 MI Primary

Addresses

Primary practice location

22101 Moross Rd
Detroit, MI 48236-2148

Mailing address

22101 Moross Rd
Detroit, MI 48236-2148

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
I20121206000337 MI Practitioner - Physician Assistant 9739331372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Sep 24, 2017 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Semi Medical Group CurrentSince Jan 11, 2019 Accepting new patients
Henry Ford Semi Medical Group Physician Assistant CurrentSince Jan 11, 2019 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Sep 24, 2017 Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22101 Moross Rd
Ste 212
Detroit, MI 48236
Phone (313) 343-3485

13350 24 Mile Rd
Ste 700
Shelby Township, MI 48315
Phone (586) 254-2777

37771 Schoenherr Rd
Ste 104
Sterling Hts, MI 48312
Phone (810) 286-0050

Interoperability endpoints

  • Direct secure messaging: jsmiley1151716@direct.hfhs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1558643510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMILEY",
        "first_name": "JONATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.