Individual provider Active NPI

Jared Paul Wilson, PA-C

  • Physician Assistant
  • Battle Creek, MI
National Provider Identifier
1699868927
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601004216 Issued in MI
Practice address
7070 E Drive North
Battle Creek, MI 49014-8562
Phone
(269) 660-1670
Fax
(269) 660-0666
NPI assigned
Sep 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004216 MI Primary
Surgical Physician Assistant 363AS0400X 5601004216 MI

Addresses

Primary practice location

7070 E Drive North
Battle Creek, MI 49014-8562

Mailing address

7070 E Drive North
Battle Creek, MI 49014-8562
Phone (269) 660-1670

Other identifiers 1

IdentifierTypeStateIssuer
5601004216OtherMILICENSE, MICHIGAN

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
I20040311001228 MI Practitioner - Physician Assistant 8628967379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology and Skin Surgery CenterGroup PAC ID 2668467838, 29 clinicians

Practice addresses (Care Compare)

2121 Spring Arbor Rd
Jackson, MI 49203-2707
Phone (517) 787-5350

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jwilson@docsdermmi.emadirect.md

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.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1699868927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7070 E DRIVE NORTH",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148562",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7070 E DRIVE NORTH",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490148562",
            "telephone_number": "269-660-1670",
            "fax_number": "269-660-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JARED",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004216",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004216",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE, MICHIGAN",
            "identifier": "5601004216",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.