Individual provider Active NPI

Julie Ann Digiovanni, PA

  • Physician Assistant
  • Kalamazoo, MI
National Provider Identifier
1730463597
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006079 Issued in MI
Practice address
200 N Park St
Kalamazoo, MI 49007-3731
Phone
(269) 384-8641
Fax
(269) 373-0123
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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 5601006079 MI Primary

Addresses

Primary practice location

200 N Park St
Kalamazoo, MI 49007-3731

Mailing address

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 382-2500

Other identifiers 2

IdentifierTypeStateIssuer
1730463597MedicaidMI
1447261730OtherMIBCBSM WMCC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct.direct@bronsonhg.org Direct Bronson Healthcare Group

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
I20111205000084 MI Practitioner - Physician Assistant 0547435430 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Michigan Cancer CenterGroup PAC ID 8628971199, 16 clinicians

Practice addresses (Care Compare)

200 N Park St
Kalamazoo, MI 49007-3731
Phone (269) 373-7488

200 N Park St
Kalamazoo, MI 49007-5341

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
56.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601006079MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
West Michigan Cancer Center Physician Assistant CurrentSince Oct 16, 2011 Accepting new patients
Bronson Methodist Hospital Physician Assistant CurrentSince Mar 1, 2021 Accepting new patients

Locations

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

200 N Park St
Kalamazoo, MI 49007
Phone (269) 373-7453

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1730463597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-382-2500",
            "fax_number": "269-373-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490073731",
            "telephone_number": "269-384-8641",
            "fax_number": "269-373-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGIOVANNI",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730463597",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM WMCC",
            "identifier": "1447261730",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct.direct@bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.