Jaclyn Elizabeth Efrusy Abbott, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704299676 Issued in MI

Practice address

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105-9484

Phone

(888) 287-1082

NPI assigned

Feb 9, 2018

Last updated

Jan 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Elizabeth Efrusy Former name

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Regents of the University of Michigan

  • Nurse Practitioner
  • Ann Arbor, MI
  • NPI 1447275102
  Medicare reassignment Care Compare group NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1629000708
  Medicare reassignment Care Compare group NPD
• Iha Health Services Corporation

  dba IHA Canton Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Canton, MI
  • NPI 1457408965
  Medicare reassignment NPD
• Iha Health Service Corporation

  dba Trinity Health IHA Medical Group OB/GYN Float

  • Obstetrics & Gynecology Physician
  • Ypsilanti, MI
  • NPI 1831053701
  NPD
• Iha Health Services Organization

  • Cardiovascular Disease Physician
  • Ypsilanti, MI
  • NPI 1487072633
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Nurse Practitioner
  • Jackson, MI
  • NPI 1366988347
  NPD
• W.a. Foote Memorial Hospital, Inc

  dba Henry Ford Allegiance Health

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1952800435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "888-287-1082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Page Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "49201",
            "country_code": "US",
            "telephone_number": "517-787-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-250-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "JACLYN",
        "middle_name": "ELIZABETH EFRUSY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-09",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704299676",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704299676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jefrusy538725@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "309 Page Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "49201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "EFRUSY",
            "middle_name": "ELIZABETH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriella Abalo
• Khadija Abbas
• Samar Abbasi, LLPC
• Emily Abbenante-Honold
• Carol Abbey-Mensah
• Kristina Ann Abbott, BSN RN
• Nicole Myung - Sun Abbott, CRNA
• Abc Dental PC (Comfort Dental Care Center)
• Abrahime Abdallah
• Ahmed Abdel-Latif, M.D.

• Primary Care Nurse Practitioner in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.