NPIMap

Individual provider Active NPI

Jacob Trombley, DO

  • Family Medicine Physician
  • Essexville, MI
National Provider Identifier
1750801239
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101022986 Issued in MI
Practice address
1458 W Center Rd Ste 1
Essexville, MI 48732-2151
Phone
(989) 895-4625
NPI assigned
Jun 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2017

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 5101022986 MI Primary

Addresses

Primary practice location

1458 W Center Rd Ste 1
Essexville, MI 48732-2151

Mailing address

401 S Ballenger Hwy
Flint, MI 48532-3638

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
I20200625001948 MI Practitioner - Family Practice 6305116989 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1105 E Cedar Ave
Gladwin, MI 48624-7003
Phone (989) 246-6490

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Gladwin CurrentSince Aug 1, 2020 Accepting new patients
Mymichigan Medical Center Alma Current Accepting new patients
Mymichigan Medical Center Gladwin CurrentSince Aug 1, 2020 Accepting new patients

Locations

321 E Warwick Dr
Alma, MI 48801
Phone (989) 463-0957

700 W 5th St
Clare, MI 48617
Phone (989) 386-9911

602 Beech St
Ste 1100
Clare, MI 48617
Phone (989) 386-9911

5694 Midland Rd
Freeland, MI 48623
Phone (989) 695-2123

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

1105 E Cedar Ave
Gladwin, MI 48624
Phone (989) 246-6490

515 Quarter St
Gladwin, MI 48624
Phone (989) 246-6201

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

2618 W Sugnet Rd
Midland, MI 48640
Phone (989) 633-5237

Interoperability endpoints

  • Direct secure messaging: jtrombley11285@mymichiganhealth.midirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498435200000",
    "number": "1750801239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S BALLENGER HWY",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 W CENTER RD STE 1",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322151",
            "telephone_number": "989-895-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLEY",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101022986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essexville, MI

Sources for this page

Verify at the official NPI Registry.