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NPI 1730077082ActiveOrganization· Physician Assistant, Medical· Troy, MI

Physician Assistant, Medical in Troy, Michigan, registered in NPPES in June 2025. The authorized official on file is Jasmine Cofield, PA-C, Medical Director. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1730077082
StatusActive
Entity typeOrganization
NPI issuedJun 25, 2025
Last updated in NPPESAug 22, 2025
Certified by providerAug 22, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Physician Assistant, Medical Primary363AM0700X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (MI)

Medicare sources and data years

Other Physician Assistant, Medical providers in Troy

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