NPIMap

Individual provider Active NPI

Paul Michael Jaklitsch, MD

  • Anesthesiology Physician
  • Grand Rapids, MI
National Provider Identifier
1659359255
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301085131 Issued in MI
Practice address
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone
(616) 364-4200
Fax
(616) 364-7347
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301085131 MI Primary
Anesthesiology Physician 207L00000X C4612 KY

Addresses

Primary practice location

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756

Mailing address

3333 Evergreen Dr NE
Grand Rapids, MI 49525-9756
Phone (616) 364-4200

Other practice location 1

4000 Wellness Dr
Midland, MI 48670-1000
Phone (989) 839-3000

Other identifiers 1

IdentifierTypeStateIssuer
4745401MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, KY, WI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050726000955 MI Practitioner - Anesthesiology 4587691043 Reassigns benefits to 4 organizations
I20251222001623 KY Practitioner - Anesthesiology 4587691043 Reassigns benefits to 1 organization
I20260130000079 WI Practitioner - Anesthesiology 4587691043 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Michigan Anesthesia PC 69 clinicians
Professional Anesthesia Services of Kentucky PLLC 351 clinicians
Anesthesia Medical Consultants, PC 87 clinicians
Mymichigan Medical Center Midland 507 clinicians

Practice addresses (Care Compare)

100 Michigan Ave NE
Grand Rapids, MI 49503-2560
Phone (616) 391-9000

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

2373 64TH St SW
2200 Southwest Surgical Center
Byron Center, MI 49315-7976
Phone (616) 364-4200

4000 Kresge Way
Louisville, KY 40207-4605
Phone (502) 897-8100

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 839-3000

Hospital & facility affiliations

  • Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222
  • Baptist Health Louisville Hospital, Louisville, KY, CCN 180130
  • University of Michigan Health - West Hospital, Wyoming, MI, CCN 230236

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C4612KYMDAnesthesiology Physician
4301085131MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Medical Consultants, PC Anesthesiology CurrentSince Jul 5, 2011 Accepting new patients
Association of Hospital Anesthesiologists SC Anesthesiology CurrentSince Feb 1, 2026 Accepting new patients
Mymichigan Medical Center Midland Anesthesiology CurrentSince Oct 15, 2025 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Anesthesiology CurrentSince Oct 12, 2025 Accepting new patients
West Michigan Anesthesia, PC Anesthesiology CurrentSince Aug 1, 2005 Accepting new patients

Locations

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

2373 64th St SW
Ste 2200
Byron Center, MI 49315
Phone (616) 643-3975

100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680

4055 Cascade Rd SE
Grand Rapids, MI 49546
Phone (616) 252-4410

3333 Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 284-3132

3333 Evergreen Dr NE
Ste 100
Grand Rapids, MI 49525

80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

736 Ford St
Kimberly, WI 54136

130 2nd St
#A107
Neenah, WI 54956

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1659359255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259756",
            "telephone_number": "616-364-4200",
            "fax_number": "616-364-7347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Wellness Dr",
            "address_purpose": "LOCATION",
            "city": "Midland",
            "state": "MI",
            "postal_code": "486701000",
            "country_code": "US",
            "telephone_number": "989-839-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAKLITSCH",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301085131",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "C4612",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4745401",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.