Individual provider Active NPI

Jonathan Moseley, PA-C

  • Physician Assistant
  • Northville, MI
National Provider Identifier
1790343267
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601011086 Issued in MI
Practice address
39901 Traditions Dr
Northville, MI 48168-9493
Phone
(248) 305-4400
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50.005951RX OH
Physician Assistant 363A00000X 5601011086 MI Primary

Addresses

Primary practice location

39901 Traditions Dr
Northville, MI 48168-9493

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

30575 Woodward Ave
Royal Oak, MI 48073-0980
Phone (248) 280-8550

Other practice location 2

45816 Schoenherr Rd
Shelby Twp, MI 48315-6028
Phone (586) 842-2400

Other practice location 3

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3761

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jonathan.moseley.1@9974.direct.athenahealth.com Health Information Exchange (HIE)

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220607002291 MI Practitioner - Physician Assistant 7113258138 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians
Michigan Orthopaedic Surgeons PLLCGroup PAC ID 7810277811, 127 clinicians

Practice addresses (Care Compare)

11900 E 12 Mile Rd
308 Amg Cardiothoracic Surgical Associa
Warren, MI 48093-3491
Phone (248) 849-2600

17877 W 14 Mile Rd
Beverly Hills, MI 48025-3127
Phone (248) 644-3920

26025 Lahser Rd
FL 2
Southfield, MI 48033-2606
Phone (248) 663-1900

27483 Dequindre Rd
Suite 204
Madison Heights, MI 48071-5711
Phone (248) 967-7326

30575 Woodward Ave
Royal Oak, MI 48073-0980
Phone (248) 280-8550

45816 Schoenherr Rd
Shelby Township, MI 48315-6028
Phone (248) 714-1635

4967 Crooks Rd
Suite 100
Troy, MI 48098-5812
Phone (248) 714-1635

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Orthopaedic Surgeons, PLLC CurrentSince Jul 29, 2024 Accepting new patients
Regents of the University of Michigan Physician Assistant CurrentSince May 24, 2022 Accepting new patients
Medical University of Ohio at Toledo Current Accepting new patients
Michigan Orthopaedic Surgeons PLLC PastSince Mar 27, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

17877 W 14 Mile Rd
Beverly Hills, MI 48025
Phone (248) 644-3920

8001 Challis Rd
Brighton, MI 48116
Phone (810) 227-9510

30575 Woodward Ave
Ste 100
Royal Oak, MI 48073
Phone (248) 280-8550

26211 Central Park Blvd
Ste 201
Southfield, MI 48076
Phone (248) 845-4381

26025 Lahser Rd
Fl 2
Southfield, MI 48033
Phone (248) 663-1900

45816 Schoenherr Rd
Utica, MI 48315
Phone (586) 842-2400

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

Interoperability endpoints

  • Direct secure messaging: jmoseley24569@direct.utoledo.edu
  • Direct secure messaging: jonathan.moseley.1@9974.direct.athenahealth.com

Organizations & group practices 9

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 5

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1790343267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39901 TRADITIONS DR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481689493",
            "telephone_number": "248-305-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30575 Woodward Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480730980",
            "country_code": "US",
            "telephone_number": "248-280-8550",
            "fax_number": "248-280-8571",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45816 Schoenherr Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Twp",
            "state": "MI",
            "postal_code": "483156028",
            "country_code": "US",
            "telephone_number": "586-842-2400",
            "fax_number": "586-991-6054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3761",
            "fax_number": "419-383-2933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSELEY",
        "first_name": "JONATHAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50.005951RX",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jonathan.moseley.1@9974.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Health",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "45816 Schoenherr Rd",
            "city": "Shelby Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483156028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

Verify at the official NPI Registry.