Individual provider Active NPI

Jessica Katherine Gust, PA

  • Physician Assistant
  • Clare, MI
National Provider Identifier
1710457148
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601008796 Issued in MI
Practice address
703 N McEwan St
Clare, MI 48617-1440
Phone
(989) 802-5000
NPI assigned
Nov 28, 2018
Last updated
Nov 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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 5601008796 MI Primary

Addresses

Primary practice location

703 N McEwan St
Clare, MI 48617-1440

Mailing address

4000 Wellness Dr
Midland, MI 48670-2000

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
I20181211001182 MI Practitioner - Physician Assistant 9234473729 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center MidlandGroup PAC ID 2264323633, 507 clinicians

Practice addresses (Care Compare)

4000 Wellness Dr
Midland, MI 48670-2000
Phone (989) 633-8018

4500 Campus Ridge Dr
Midland, MI 48640-6123
Phone (989) 837-9250

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Wyandotte Hospital CurrentSince Aug 1, 2023 Accepting new patients
Mymichigan Medical Center Alpena CurrentSince Nov 28, 2018 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Nov 1, 2021 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Aug 1, 2023 Accepting new patients
Mymichigan Medical Group CurrentSince Nov 28, 2018 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Nov 1, 2021 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Dec 1, 2022 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2022 Accepting new patients

Locations

703 N McEwan St
Clare, MI 48617
Phone (989) 802-5000

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

609 Quarter St
Gladwin, MI 48624
Phone (989) 246-6371

815 N Clare Ave
Harrison, MI 48625
Phone (989) 539-4096

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

4500 N Campus Ridge Dr
Midland, MI 48640
Phone (989) 837-9250

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

Organizations & group practices 10

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 3

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": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1710457148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 WELLNESS DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486702000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MCEWAN ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171440",
            "telephone_number": "989-802-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUST",
        "first_name": "JESSICA",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

Verify at the official NPI Registry.