Individual provider Active NPI

Jacob Ryan Compton, DO

  • Internal Medicine Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1942794458
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101026132 Issued in MI
Practice address
19251 Mack Ave Ste 333
Grosse Pointe Woods, MI 48236-2898
Phone
(313) 343-7280
NPI assigned
Jun 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101026132 MI Primary
Internal Medicine Physician 207R00000X 5101024103 MI
Student in an Organized Health Care Education/Training Program 390200000X 5101024103 MI

Addresses

Primary practice location

19251 Mack Ave Ste 333
Grosse Pointe Woods, MI 48236-2898

Mailing address

22101 Moross Rd Ste 50
Detroit, MI 48236-2172
Phone (313) 343-7774

Other practice location 1

22101 Moross Rd Ste 50
Detroit, MI 48236
Phone (313) 343-7774

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210514001042 MI Practitioner - Internal Medicine 6406102623 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Internal Medicine Associates P.C.Group PAC ID 8022097963, 64 clinicians

Practice addresses (Care Compare)

3955 Patient Care Dr
Lansing, MI 48911-4299
Phone (517) 374-7600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101026132MIMDInternal Medicine Physician
5101024103MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Eaton Rapids Medical Center CurrentSince Oct 25, 2022 Accepting new patients
Eaton Rapids Medical Center Current Accepting new patients
Eaton Rapids Medical Center CurrentSince Oct 25, 2022 Accepting new patients
Capital Internal Medicine Associates P.C. Internal Medicine CurrentSince May 1, 2022 Accepting new patients
Eaton Rapids Medical Center CurrentSince Oct 25, 2022 Accepting new patients
McLaren Greater Lansing Past Accepting new patients

Locations

1500 S Main St
Eaton Rapids, MI 48827
Phone (517) 663-2671

3955 Patient Care Dr
Lansing, MI 48911
Phone (517) 374-7600

3955 Patient Care Dr
Ste A
Lansing, MI 48911
Phone (517) 374-7600

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1942794458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD STE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362172",
            "telephone_number": "313-343-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE STE 333",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362898",
            "telephone_number": "313-343-7280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22101 Moross Rd Ste 50",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48236",
            "country_code": "US",
            "telephone_number": "313-343-7774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMPTON",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101026132",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101024103",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "5101024103",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.