NPIMap

Individual provider Active NPI

Jessica Elizabeth Finnerty, DO

  • Family Medicine Physician
  • Shelby Township, MI
National Provider Identifier
1730530270
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022745 Issued in MI
Practice address
49310 Van Dyke Ave
Shelby Township, MI 48317-1337
Phone
(586) 731-8900
Fax
(586) 731-7762
NPI assigned
Jun 27, 2016
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101022745 MI Primary

Addresses

Primary practice location

49310 Van Dyke Ave
Shelby Township, MI 48317-1337

Mailing address

2689 Solution Center
Chicago, IL 60677-0001
Phone (586) 329-1880

Other identifiers 2

IdentifierTypeStateIssuer
5101022745OtherMIOSTEOPATHIC MEDICINE AND SURGERY PHYSICIAN LICENSE
5315090564OtherMICONTROLLED SUBSTANCE LICENSE

Other names 1

  • Jessica Elizabeth Krol Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jkrol606381@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190625003797 MI Practitioner - Family Practice 4284928706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

49310 Van Dyke Ave
Shelby Township, MI 48317-1337
Phone (586) 731-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101022745MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Mt. Clemens, PC Current Accepting new patients
Henry Ford Physician Partners CurrentSince Sep 1, 2022 Accepting new patients
Henry Ford Physician Partners Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Alliance Health Professionals, PLLC CurrentSince May 18, 2019 Accepting new patients

Locations

2689 Solution Ctr
Chicago, IL 60677

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

49310 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 731-8900

Interoperability endpoints

  • Direct secure messaging: jkrol606381@direct.hfhs.org

Organizations & group practices 5

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1730530270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 SOLUTION CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606770001",
            "telephone_number": "586-329-1880",
            "fax_number": "586-231-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49310 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171337",
            "telephone_number": "586-731-8900",
            "fax_number": "586-731-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINNERTY",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICINE AND SURGERY PHYSICIAN LICENSE",
            "identifier": "5101022745",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315090564",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jkrol606381@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "49310 Van Dyke Ave",
            "city": "Shelby Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483171337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KROL",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.