Individual provider Active NPI

Jessica Lee Firestone

  • Medical Physician Assistant
  • Muskegon, MI
National Provider Identifier
1881266153
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4807 Issued in TN
Practice address
1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833
Phone
(231) 733-1326
Fax
(231) 733-5212
NPI assigned
Jul 15, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4807 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833

Mailing address

1400 Mercy Dr Ste 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

Other practice location 1

3443 Dickerson Pike Ste 590
Nashville, TN 37207-2520
Phone (615) 988-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MI2 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
I20220111000965 TN Practitioner - Physician Assistant 7012309602 Reassigns benefits to 1 organization
I20240917000118 MI Practitioner - Physician Assistant 7012309602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mid West Medical College, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Mercy Dr
Muskegon, MI 49444-1836

1400 Mercy Dr
Suite 100
Muskegon, MI 49444-1833
Phone (231) 733-1326

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.76 of 100Reported as group
Quality
100
Promoting interoperability
91
Improvement activities
40
Cost
96.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4807TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic Associates of Muskegon, PC CurrentSince Aug 20, 2024 Accepting new patients
Premier Pain & Spine Center, PLLC CurrentSince Oct 6, 2021 Accepting new patients

Locations

1400 Mercy Dr
Ste 100
Muskegon, MI 49444
Phone (231) 733-1326

3443 Dickerson Pike
Ste 590
Nashville, TN 37207
Phone (615) 637-7463

Interoperability endpoints

  • Direct secure messaging: jessica.firestone.1@29636.direct.athenahealth.com

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": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1881266153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MERCY DR STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441833",
            "telephone_number": "231-733-1326",
            "fax_number": "231-733-5212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MERCY DR STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441833",
            "telephone_number": "231-733-1326",
            "fax_number": "231-733-5212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3443 Dickerson Pike Ste 590",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372072520",
            "country_code": "US",
            "telephone_number": "615-988-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIRESTONE",
        "first_name": "JESSICA",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "4807",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.