Individual provider Active NPI

Janelle Maureen Mirch, PA-C

  • Physician Assistant
  • Troy, MI
National Provider Identifier
1649731076
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601009411 Issued in MI
Practice address
44199 Dequindre Rd Ste 315
Troy, MI 48085-1128
Phone
(248) 964-1160
NPI assigned
Mar 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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 5601009411 MI Primary

Addresses

Primary practice location

44199 Dequindre Rd Ste 315
Troy, MI 48085-1128

Mailing address

587 Ridgewood Rd
Rochester, MI 48306-2647
Phone (248) 431-6742

Other practice location 1

587 Ridgewood Rd
Rochester, MI 48306-2647
Phone (248) 431-6742

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmirch994478@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
I20190830000711 MI Practitioner - Physician Assistant 4981932852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Eastern Virginia Medical School, 2019
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

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535

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
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601009411MIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jmirch1247131@epic00.shdirect.org

Organizations & group practices 1

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": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1649731076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 RIDGEWOOD RD",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483062647",
            "telephone_number": "248-431-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE RD STE 315",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851128",
            "telephone_number": "248-964-1160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "587 Ridgewood Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MI",
            "postal_code": "483062647",
            "country_code": "US",
            "telephone_number": "248-431-6742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRCH",
        "first_name": "JANELLE",
        "middle_name": "MAUREEN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-28",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601009411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmirch994478@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "44199 Dequindre Rd Ste 315",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.