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JUSTIN PATRICK PA
NPI 1366120982
Physician Assistant in Southfield, MI

Active since July 05, 2023PECOS Enrolled
24725 W 12 MILE RD STE 260, SOUTHFIELD, MI 48034(248) 382-8052 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 18, 2023, Jul 5, 2023 (2 updates tracked since 2023).

About Justin Patrick Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN PATRICK PA (NPI 1366120982) is an individual physician assistant in Southfield, Michigan, licensed in Michigan (5601011860) and active in the NPI registry since July 2023. He is enrolled in Medicare PECOS, is affiliated with Trinity Health Oakland Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1366120982
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJUSTIN PATRICKCredential: PA
Location Address24725 W 12 MILE RD STE 260Southfield, MI 48034-8310
Mailing Address2701 Park AveDetroit, MI 48201-3041
Phone(248) 382-8052
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateJuly 5, 2023
Last NPPES UpdateOctober 18, 20232 updates tracked since enumeration
NPPES CertifiedOctober 18, 2023
✔ NPI 1366120982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MI · 5601011860
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
24725 W 12 MILE RD STE 260, Southfield, MI 48034
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Patrick Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7113373663
PECOS Enrollment IDI20231019002959
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Trinity Health Oakland Hospital

Acute Care Hospitals · Pontiac, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230029
Location44405 Woodward AvePontiac, MI 48341 · Oakland County
Emergency services Birthing friendly

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230269
Location44201 Dequindre RoadTroy, MI 48085 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NICHOLAS ARISTON MALLES III DC
Chiropractor
24725 W 12 MILE RD STE 260
SOUTHFIELD, MI 48034
Oakland County (248) 353-2225
RENEW REHABILITATIVE MEDICINE
Physical Medicine & Rehabilitation (Sports Medicine)
24725 W 12 MILE RD STE 260
SOUTHFIELD, MI 48034
Oakland County (248) 382-8052
RENEW SPINE AND REHAB INC
Emergency Medicine (Sports Medicine)
24725 W 12 MILE RD STE 260
SOUTHFIELD, MI 48034
Oakland County (248) 353-2225
AXIS PT
Physical Therapist
24725 W 12 MILE RD STE 260
SOUTHFIELD, MI 48034
Oakland County (248) 550-4800

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 Justin Patrick's NPI number?

The NPI number for Justin Patrick is 1366120982. It was assigned to this individual provider in the NPPES registry on July 5, 2023.

Where is Justin Patrick located?

Justin Patrick practices at 24725 W 12 Mile Rd Ste 260, Southfield, MI 48034. The listed phone number is (248) 382-8052.

What is Justin Patrick's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Justin Patrick enrolled in Medicare?

Yes. Justin Patrick is registered in the Medicare PECOS enrollment system.

What insurance does Justin Patrick accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Justin Patrick 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 Justin Patrick affiliated with any hospitals?

According to CMS data, Justin Patrick is affiliated with Trinity Health Oakland Hospital and Beaumont Hospital, Troy.

When was this NPI record last updated?

The NPPES record for Justin Patrick was last updated on October 18, 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.