Individual provider Active NPI

Jennifer Castillo Podgorny, PA-C

  • Physician Assistant
  • Dearborn, MI
National Provider Identifier
1710181813
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18181 Oakwood Blvd Ste 403
Dearborn, MI 48124-3960
Phone
(313) 438-5560
Fax
(313) 438-5575
NPI assigned
Jun 13, 2007
Last updated
Mar 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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 NU Primary

Addresses

Primary practice location

18181 Oakwood Blvd Ste 403
Dearborn, MI 48124-3960

Mailing address

25500 Meadowbrook Rd Ste 150
Novi, MI 48375-1880
Phone (248) 784-3667

Other identifiers 1

IdentifierTypeStateIssuer
5601005056OtherMISTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jpodgor1@direct.hfhs.org
Direct Messaging Address jennifer.podgorny.p1@direct.mhsineuro.nextgenshare.com

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
I20070823000697 MI Practitioner - Physician Assistant 3971695701 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15717 15 Mile Rd
Clinton Township, MI 48035-2101

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

18181 Oakwood Blvd
Suite 403
Dearborn, MI 48124-3960
Phone (877) 784-3667

29275 Northwestern Hwy
Suite 100
Southfield, MI 48034-5700
Phone (248) 351-6300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Macomb Hospital Corporation CurrentSince Oct 7, 2017 Accepting new patients
Henry Ford Macomb Hospital Corporation CurrentSince Oct 7, 2017 Accepting new patients
University Neurosurgical Associates, PC CurrentSince May 1, 2016 Accepting new patients
University Neurosurgical Associates, PC CurrentSince May 1, 2016 Accepting new patients
University Neurosurgical Associates Past Accepting new patients
Oakwood Group IX, LLC Past Accepting new patients

Locations

2319 Momentum Pl
Chicago, IL 60689

15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800

15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300

18181 Oakwood Blvd
Ste 403
Dearborn, MI 48124
Phone (313) 438-5560

25500 Meadowbrook Rd
Ste 150
Novi, MI 48375
Phone (248) 784-3667

29275 Northwestern Hwy
Ste 100
Southfield, MI 48034
Phone (248) 351-6300

Interoperability endpoints

  • Direct secure messaging: jennifer.podgorny.p1@direct.mhsineuro.nextgenshare.com
  • Direct secure messaging: jpodgorny282285@direct.hfhs.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1710181813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25500 MEADOWBROOK RD STE 150",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751880",
            "telephone_number": "248-784-3667",
            "fax_number": "248-869-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD STE 403",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243960",
            "telephone_number": "313-438-5560",
            "fax_number": "313-438-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODGORNY",
        "first_name": "JENNIFER",
        "middle_name": "CASTILLO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5601005056",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpodgor1@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jennifer.podgorny.p1@direct.mhsineuro.nextgenshare.com",
            "affiliation": "N",
            "address_1": "18181 Oakwood Blvd Ste 403",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481243960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.