Individual provider Active NPI

Jessica Persaud, PA-C

  • Surgical Physician Assistant
  • Troy, MI
National Provider Identifier
1831684968
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
5601008604 Issued in MI
Practice address
44201 Dequindre Rd
Troy, MI 48085-1117
Phone
(248) 964-5000
NPI assigned
Jul 1, 2018
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601008604 MI
Physician Assistant 363A00000X 50.006623RX OH
Surgical Physician Assistant 363AS0400X 5601008604 MI Primary

Addresses

Primary practice location

44201 Dequindre Rd
Troy, MI 48085-1117

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

2751 Bay Park Dr # 300&303
Oregon, OH 43616-4921
Phone (419) 693-0711

Other practice location 2

33000 Palmer Rd
Westland, MI 48186-5517
Phone (734) 729-1800

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jpersaud208511@epicdirect.promedica.org
Direct Messaging Address jpersaud3357957@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180718000785 MI Practitioner - Physician Assistant 7214284512 Reassigns benefits to 3 organizations
I20201023000489 OH Practitioner - Physician Assistant 7214284512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Toledo College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

2109 Hughes Dr
Suite 450
Toledo, OH 43606-5102
Phone (419) 291-2003

2801 Bay Park Dr
Oregon, OH 43616-4920
Phone (419) 690-7709

28100 Grand River Ave
Farmington Hills, MI 48336-5970

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601008604MIMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians Physician Assistant CurrentSince Nov 1, 2020 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Aug 11, 2025 Accepting new patients
Promedica Central Physicians CurrentSince Nov 1, 2020 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

2751 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7596

2751 Bay Park Dr
#300303
Oregon, OH 43616
Phone (419) 693-0711

2751 Bay Park Dr
Ste 303
Oregon, OH 43616
Phone (419) 690-7676

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1530403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1831684968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44201 DEQUINDRE RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851117",
            "telephone_number": "248-964-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2751 Bay Park Dr # 300&303",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436164921",
            "country_code": "US",
            "telephone_number": "419-693-0711",
            "fax_number": "419-693-2320",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "33000 Palmer Rd",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481865517",
            "country_code": "US",
            "telephone_number": "734-729-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERSAUD",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-01",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008604",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.006623RX",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601008604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpersaud208511@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpersaud3357957@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "44201 Dequindre Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480851117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.