Jacob William Fishbaugh, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10434 Issued in GA

Practice address

3537 W Front St Ste a
Traverse City, MI 49684-7942

Phone

(231) 935-0338

Fax

(231) 935-0569

NPI assigned

Jun 4, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Medical Center Hospital, Traverse City, MI, CCN 230097
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081
• Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322
• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Munson Healthcare Otsego Memorial Hospital

  • Rural Health Clinic/Center
  • Gaylord, MI
  • NPI 1164628426
  Medicare reassignment Care Compare group
• Munson Medical Center

  • Endocrinology, Diabetes & Metabolism Physician
  • Traverse City, MI
  • NPI 1083761860
  Medicare reassignment Care Compare group
• Munson Healthcare Otsego Memorial Hospital

  • Rural Health Clinic/Center
  • Indian River, MI
  • NPI 1639420557
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Munson Medical Center

  • Urology Physician
  • Traverse City, MI
  • NPI 1427466499
  NPD
• Munson Medical Center

  • Psychiatric Hospital Unit
  • Traverse City, MI
  • NPI 1891586103
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • General Practice Physician
  • Gaylord, MI
  • NPI 1821064643
  NPD (past)
• Munson Medical Center

  • Family Medicine Physician
  • Traverse City, MI
  • NPI 1881623031
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754
  Care Compare affiliation
• Munson Healthcare Charlevoix Hospital

  • Critical Access Hospital
  • Charlevoix, MI
  • NPI 1346260692
  Care Compare affiliation
• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation
• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360
  Care Compare affiliation

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1710554274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842386",
            "telephone_number": "231-392-0773",
            "fax_number": "231-935-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 W FRONT ST STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847942",
            "telephone_number": "231-935-0338",
            "fax_number": "231-935-0569"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "334 Smith Ave",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "317925533",
            "country_code": "US",
            "telephone_number": "574-904-6141",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "419 S Coral St",
            "address_purpose": "LOCATION",
            "city": "Kalkaska",
            "state": "MI",
            "postal_code": "496462503",
            "country_code": "US",
            "telephone_number": "231-258-7530",
            "fax_number": "231-258-7555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "829 N Center Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Gaylord",
            "state": "MI",
            "postal_code": "497351599",
            "country_code": "US",
            "telephone_number": "319-350-3382",
            "fax_number": "231-935-0569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "224 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "MI",
            "postal_code": "496359658",
            "country_code": "US",
            "telephone_number": "231-935-0338",
            "fax_number": "231-935-0568",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1619 Anderson Rd",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709256",
            "country_code": "US",
            "telephone_number": "231-935-0338",
            "fax_number": "231-935-3421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHBAUGH",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-04",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Firm Footings, LLC
• Ernie G Fischer, MD
• Nathan Fischer, MD
• Olivia Fish
• Tara L Fishback, PA-C
• Karla A Fishburn, RN
• Brian R Fisher, DDS
• Daniel Robert Fisher, DDS
• Larissa Lynn Fisher, PA
• Chase Anthony Fitch

• Physician Assistant in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.

Verify at the official NPI Registry.