JACKQULYN BROWN
NPI 1194591719
Nurse Practitioner - Family in Southfield, MI
About Jackqulyn Brown NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKQULYN BROWN (NPI 1194591719) is an individual family provider in Southfield, Michigan, licensed in Michigan (4704342245) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital Royal Oak, and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jackqulyn Brown is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jackqulyn Brown reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Southfield, MI 48075
- Reassigned Medicare billing, Michigan enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Beaumont Hospital Royal Oak
Acute Care Hospitals · Royal Oak, MIBeaumont Hospital - Farmington Hills
Acute Care Hospitals · Farmington Hills, MIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48075 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jackqulyn Brown's NPI number?
The NPI number for Jackqulyn Brown is 1194591719. It was assigned to this individual provider in the NPPES registry on November 27, 2023.
Where is Jackqulyn Brown located?
Jackqulyn Brown practices at 20755 Greenfield Rd Ste 100, Southfield, MI 48075. The listed phone number is (248) 557-0507.
What is Jackqulyn Brown's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Jackqulyn Brown enrolled in Medicare?
Yes. Jackqulyn Brown is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jackqulyn Brown's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jackqulyn Brown reassigns Medicare benefits to Rsmd PLLC (Southfield, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jackqulyn Brown's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jackqulyn Brown accept?
Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and Priority Health list Jackqulyn Brown as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Jackqulyn Brown affiliated with any hospitals?
According to CMS data, Jackqulyn Brown is affiliated with Beaumont Hospital Royal Oak and Beaumont Hospital - Farmington Hills.
When was this NPI record last updated?
The NPPES record for Jackqulyn Brown was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jackqulyn Brown · NPI 1194591719
Family physician in Southfield, Michigan. Individual provider, active in the CMS NPPES registry since November 27, 2023.
## Identity
- **NPI:** 1194591719 (Entity type: Individual)
- **Enumerated:** November 27, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 4704342245 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 20755 GREENFIELD RD STE 100, Southfield, MI 48075-5400
- **Phone:** (248) 557-0507
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Rsmd PLLC (NPI 1053663575, Southfield, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** November 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1194591719) · Data from the CMS NPPES public registry.