Organization Active NPI

Jill M Paveglio, MD PLC

  • Family Medicine Physician
  • Saginaw, MI
National Provider Identifier
1730669151
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JP084288 Issued in MI
Legal business name
JILL M PAVEGLIO, MD PLC
Practice address
5560 Gratiot Rd Ste B
Saginaw, MI 48638-6091
Phone
(989) 558-0050
Fax
(989) 249-0227
NPI assigned
Aug 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Daniella Provost
Title
Billing Service
Phone
(989) 249-1922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X JP084288 MI Primary

Addresses

Primary practice location

5560 Gratiot Rd Ste B
Saginaw, MI 48638-6091

Mailing address

5560 Gratiot Rd Ste B
Saginaw, MI 48638-6091
Phone (989) 558-0050

Other identifiers 1

IdentifierTypeStateIssuer
1538259494OtherMINPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dprovost@advancedpracticemgmt.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181001001497 MI Part B Supplier - Clinic/Group Practice 5395096309 Receives reassigned benefits from 2 practitioners
Practice locations: Saginaw, MI

National Provider Directory

National Provider Directory

Locations

5560 Gratiot Rd
Ste B
Saginaw, MI 48638
Phone (989) 558-0050

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1730669151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 GRATIOT RD STE B",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386091",
            "telephone_number": "989-558-0050",
            "fax_number": "989-249-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 GRATIOT RD STE B",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486386091",
            "telephone_number": "989-558-0050",
            "fax_number": "989-249-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL M PAVEGLIO, MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2023-04-06",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "PROVOST",
        "authorized_official_first_name": "DANIELLA",
        "authorized_official_title_or_position": "BILLING SERVICE",
        "authorized_official_telephone_number": "989-249-1922"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JP084288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1538259494",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dprovost@advancedpracticemgmt.com",
            "affiliation": "N",
            "endpointDescription": "Jill Paveglio, M.D.  Advanced Practice Management",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5560 Gratiot Rd Ste B",
            "city": "Saginaw",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486386091",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.