Active NPI
Jessica M Macdougall, PA
- Dermatology Physician
- Troy, MI
National Provider Identifier
1700932860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 5601003859
- Practice address
- 2221 Livernois Road
Suite 101
Troy, MI 48083 - Phone
- (248) 362-3500
- Fax
- (248) 362-1941
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 5601003859 | MI | Primary |
Addresses
Primary practice location
2221 Livernois Road
Suite 101
Troy, MI 48083
Mailing address
11850 Davisburg Road
Davisburg, MI 48350
Phone (248) 722-2550
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Wayne State University School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
215 E Big Beaver Rd
Suite 200
Troy, MI 48083-1216
Phone (248) 362-3500
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601003859 | MI | MD | Dermatology Physician |
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.
-
- Dermatology Physician
- Troy, MI
- NPI 1962689273
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700932860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11850 DAVISBURG ROAD",
"city": "DAVISBURG",
"state": "MI",
"postal_code": "48350",
"telephone_number": "248-722-2550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 LIVERNOIS ROAD",
"address_2": "SUITE 101",
"city": "TROY",
"state": "MI",
"postal_code": "48083",
"telephone_number": "248-362-3500",
"fax_number": "248-362-1941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACDOUGALL",
"first_name": "JESSICA",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MI",
"license": "5601003859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.