Jennifer Yelizarov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008271 Issued in MI

Practice address

15855 19 Mile Rd
Clinton TWP, MI 48038-3504

Phone

(586) 263-2300

NPI assigned

Jul 14, 2017

Last updated

Mar 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Macomb Hospital CorporationGroup PAC ID 7911808381, 349 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jyeliza1@hfhs.org
• Direct secure messaging: jyelizarov684063@direct.hfhs.org

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.

• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Macomb Family Medicine

  • Family Medicine Physician
  • Clinton TWP, MI
  • NPI 1134265986
  Medicare reassignment Care Compare group NPD
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  Medicare reassignment
• Independent Observation Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1700119500
  Medicare reassignment
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1821510421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 S ALEXANDER AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672875",
            "telephone_number": "248-470-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15855 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383504",
            "telephone_number": "586-263-2300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7107 N Wayne Rd",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481852172",
            "country_code": "US",
            "telephone_number": "408-396-2646",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37000 Grand River Ave Ste 120",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483352868",
            "country_code": "US",
            "telephone_number": "248-849-3485",
            "fax_number": "248-849-2052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YELIZAROV",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jyeliza1@hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jyelizarov684063@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• WSSH Powerback Rehabilitation Services, LLC
• Tyler Wundrach, PA-C
• Elizabeth Wynne
• Amjad M Yaish, D.O.
• Linda R Yaldo, CM
• Tae Sik Yook, MD
• You Matter Therapy Solutions Inc
• Brian Young
• Kyle Young
• Ramiz Yousif, PHARMD

• Physician Assistant in Clinton TWP, MI
• Providers in Clinton TWP, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.