Individual provider Active NPI

Jasmin Mary

  • Primary Care Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1851263321
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704382277 Issued in MI
Practice address
19000 St Joes Pkwy Ste 140
Livonia, MI 48152-1477
Phone
(734) 213-3688
NPI assigned
Sep 23, 2025
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704382277 MI Primary

Addresses

Primary practice location

19000 St Joes Pkwy Ste 140
Livonia, MI 48152-1477

Mailing address

6666 Torybrooke Cir
West Bloomfield, MI 48323-2158

Other practice location 1

5777 W Maple Rd Ste 190
West Bloomfield, MI 48322-4448
Phone (248) 893-6022

Other practice location 2

1600 S Canton Center Rd
Canton, MI 48188-1992
Phone (734) 844-8743

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
I20251027000754 MI Practitioner - Nurse Practitioner 4789173212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Michigan Medical School, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

1255 E M
Pinckney, MI 48169-8133
Phone (734) 878-1000

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

19000 St Joes Pkwy
Livonia, MI 48152-1477

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

23200 Pontiac TRL
South Lyon, MI 48178-1983

29370 Plymouth Rd
Suite 100
Livonia, MI 48150-2399
Phone (734) 844-5212

4200 Whitehall Dr
Ann Arbor, MI 48105-9694

4400 Highland Rd
Waterford, MI 48328-1222
Phone (248) 618-6000

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5505 S Old US
Brighton, MI 48116-7524

5505 S Old US 23
101 Thimg Lifestyle Medicine Primary Care E
Brighton, MI 48116-7524
Phone (734) 887-7888

5789 S Main St
Clarkston, MI 48346-2959

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704382277MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Current Accepting new patients
Iha Health Service Corporation CurrentSince Nov 3, 2025 Accepting new patients
Iha Health Services Corporation CurrentSince Nov 3, 2025 Accepting new patients

Locations

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

1600 S Canton Center Rd
Canton, MI 48188
Phone (734) 398-7557

49650 Cherry Hill Rd
Ste 120
Canton, MI 48187
Phone (734) 398-7800

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

19000 St Joes Pkwy
Ste 140
Livonia, MI 48152
Phone (734) 213-3688

1255 E M 36
Pinckney, MI 48169
Phone (734) 878-1000

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: jmary4608919@direct.trinity-health.org

Organizations & group practices 3

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": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1851263321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6666 TORYBROOKE CIR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 ST JOES PKWY STE 140",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521477",
            "telephone_number": "734-213-3688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5777 W Maple Rd Ste 190",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483224448",
            "country_code": "US",
            "telephone_number": "248-893-6022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 S Canton Center Rd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "MI",
            "postal_code": "481881992",
            "country_code": "US",
            "telephone_number": "734-844-8743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARY",
        "first_name": "JASMIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704382277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.