Elizabeth F Jakobcic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005893 Issued in MI

Practice address

43494 Woodward Ave
Bloomfield Hills, MI 48302-5052

Phone

(248) 332-4629

Fax

(248) 322-5490

NPI assigned

Dec 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1639472376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43494 WOODWARD AVE",
            "address_2": "SUITE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025052",
            "telephone_number": "248-332-4629",
            "fax_number": "248-322-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43494 WOODWARD AVE",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025052",
            "telephone_number": "248-332-4629",
            "fax_number": "248-322-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKOBCIC",
        "first_name": "ELIZABETH",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-20",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Leigh Jacob, RDH
• Stacey Jacobson, DPT
• Madhu C Jagadish, P.A.C.
• Pranav M Jagtap, MD
• Aayu Deergha Jain
• Nisha Jambulingam, DO
• Hanna Jamel
• James Richard Spears MD PLLC
• Ellen Amanda Janetzke, M.D.
• Janie Bishop LLC

• Physician Assistant in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.