Individual provider Active NPI

Jenny S Pateryn, P.A.-C

  • Medical Physician Assistant
  • Ann Arbor, MI
National Provider Identifier
1891780789
Registry record updated Jul 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601001549 Issued in MI
Practice address
1500 East Medical Center Drive
2ND Floor Taubman Center Recp F
Ann Arbor, MI 48109-5332
Phone
(734) 936-5738
Fax
(734) 936-6927
NPI assigned
Sep 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601001549 MI Primary

Addresses

Primary practice location

1500 East Medical Center Drive
2ND Floor Taubman Center Recp F
Ann Arbor, MI 48109-5332

Mailing address

29355 Northwestern Hwy
# 302
Southfield, MI 48034-1053
Phone (734) 936-2047

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5601001549MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Podiatry PC PastSince Jan 21, 2024 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1891780789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29355 NORTHWESTERN HWY",
            "address_2": "# 302",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341053",
            "telephone_number": "734-936-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 EAST MEDICAL CENTER DRIVE",
            "address_2": "2ND FLOOR TAUBMAN CENTER RECP F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095332",
            "telephone_number": "734-936-5738",
            "fax_number": "734-936-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERYN",
        "first_name": "JENNY",
        "middle_name": "S",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601001549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.