Jason Porter Hogaboam, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101019788 Issued in MI

Practice address

20599 Mack Ave
Grosse Pointe Medpost Urgent Care
Grosse Pointe Woods, MI 48236-1656

Phone

(517) 279-5400

NPI assigned

Jul 1, 2012

Last updated

Jan 24, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Family Medicine, WA

  Medicare reassignment Care Compare group NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1341100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1770847139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 SANDALWOOD DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851643",
            "telephone_number": "509-264-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20599 MACK AVE",
            "address_2": "GROSSE POINTE MEDPOST URGENT CARE",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361656",
            "telephone_number": "517-279-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGABOAM",
        "first_name": "JASON",
        "middle_name": "PORTER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-01",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101019788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "A26570059",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald D Hertz, DO
• Lauryn Hicks-Watkins
• Raymond C Hilu, MD
• Schtiffanee Nicole Hinton-Lefedor
• Jaramie Hinton-McMath
• Keith Delano Hollowell Sr.
• Cassidy Ann Holton
• William Franklin Hoover Jr.
• Britnie Houston
• Nicole Marie Howard

• Family Medicine Physician in Grosse Pointe Woods, MI
• Providers in Grosse Pointe Woods, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2017; 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.

Verify at the official NPI Registry.