Active NPI
Jonathan D Thelen, PA-C
- Physician Assistant
- East Lansing, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601005596
- Practice address
- 1650 Ramblewood Dr Ste 100
East Lansing, MI 48823-7396 - Phone
- (517) 332-1200
- Fax
- (517) 351-7122
- NPI assigned
- Aug 19, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601005596 | MI | Primary |
Addresses
Primary practice location
1650 Ramblewood Dr Ste 100
East Lansing, MI 48823-7396
Mailing address
1650 Ramblewood Dr Ste 100
East Lansing, MI 48823-7396
Phone (517) 332-1200
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090928000375 | MI | Practitioner - Physician Assistant | 1052467354 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Troy Gastroenterology PC
Practice addresses (Care Compare)
1035 Charlevoix Dr
Grand Ledge, MI 48837-2223
Phone (517) 332-1200
1650 Ramblewood Dr
Suite 100
East Lansing, MI 48823-7396
Phone (517) 332-1200
Hospital & facility affiliations
- Edward W Sparrow Hospital
- McLaren Greater Lansing
- University of Michigan Health - Sparrow Eaton
- Eaton Rapids Medical Center
- University of Michigan Health- Sparrow Clinton
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Troy Gastroenterology, PC | Current | Accepting new patients |
Locations
1701 South Blvd E
Ste 300
Rochester Hills, MI 48307
Phone (248) 844-9710
50438 Van Dyke Ave
Shelby Township, MI 48317
Phone (586) 726-8423
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Troy, MI
- NPI 1740232701
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lansing, MI
- NPI 1073588711
Hospital
-
- General Acute Care Hospital
- Lansing, MI
- NPI 1760710719
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1760614101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 RAMBLEWOOD DR STE 100",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488237396",
"telephone_number": "517-332-1200",
"fax_number": "517-351-7122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 RAMBLEWOOD DR STE 100",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488237396",
"telephone_number": "517-332-1200",
"fax_number": "517-351-7122"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THELEN",
"first_name": "JONATHAN",
"middle_name": "D",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-19",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601005596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; 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.