Individual provider Active NPI

Jessica Ann Simerly, AGACNP

  • Adult Health Nurse Practitioner
  • Grosse Pointe, MI
National Provider Identifier
1598276818
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704247668 Issued in MI
Practice address
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone
(313) 473-1605
Fax
(313) 473-1934
NPI assigned
Oct 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704247668 MI
Nurse Practitioner 363L00000X 4704247668 MI
Acute Care Nurse Practitioner 363LA2100X 2017016632 MI
Adult Health Nurse Practitioner 363LA2200X 4704247668 MI Primary

Addresses

Primary practice location

468 Cadieux Rd
Grosse Pointe, MI 48230-1507

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

41455 Fret Rd
Belleville, MI 48111-3004
Phone (734) 787-1825

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsimerly113961@direct.beaumont.edu

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
I20180112000492 MI Practitioner - Nurse Practitioner 7315206612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

28100 Grand River Ave
Farmington Hills, MI 48336-5970

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1705

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.37 of 100Reported as group
Quality
66.73
Promoting interoperability
100
Improvement activities
40
Cost
70.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704247668MIMDRegistered Nurse
2017016632MIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group- Specialty Services CurrentSince Jun 28, 2021 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jul 20, 2018 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: jsimerly1256004@epic00.shdirect.org
  • Direct secure messaging: jsimerly421213@direct.hfhs.org

Organizations & group practices 2

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 2

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": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1598276818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 CADIEUX RD",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482301507",
            "telephone_number": "313-473-1605",
            "fax_number": "313-473-1934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41455 Fret Rd",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "MI",
            "postal_code": "481113004",
            "country_code": "US",
            "telephone_number": "734-787-1825",
            "fax_number": "734-787-1825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMERLY",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704247668",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704247668",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "2017016632",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704247668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsimerly113961@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "468 Cadieux Rd",
            "city": "Grosse Pointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482301507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grosse Pointe, MI

Sources for this page

Verify at the official NPI Registry.