Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JACLYN RENEE WITHROW PA-C
NPI 1629625546
Physician Assistant in Royal Oak, MI

Q: What is Jaclyn Withrow's NPI number?

The NPI number for Jaclyn Withrow is 1629625546. It was assigned to this individual provider in the NPPES registry on August 26, 2019. The provider is also known as Jaclyn Renee Dibartolomeo PA.

Q: What is Jaclyn Withrow's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Withrow was last updated on August 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 days 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.

Active since August 26, 2019PECOS Enrolled

3601 W 13 MILE RD, ROYAL OAK, MI 48073(248) 898-5000(248) 898-0015 Get Directions Write a Review

NPPES record last updated: August 28, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 28, 2026, Dec 29, 2020, Aug 26, 2019 (3 updates tracked since 2019).

On this page

About Jaclyn Renee Withrow Pa-c NPPES

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

JACLYN RENEE WITHROW PA-C (NPI 1629625546) is an individual physician assistant in Royal Oak, Michigan, licensed in Michigan (5601009625) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Beaumont Hospital Royal Oak, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1629625546

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJACLYN RENEE WITHROWCredential: PA-C

Location Address3601 W 13 MILE RDRoyal Oak, MI 48073-6712

Mailing Address26901 Beaumont Blvd Ste 3dSouthfield, MI 48033-3849

Phone(248) 898-5000

Fax(248) 898-0015

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateAugust 26, 2019

Last NPPES UpdateAugust 28, 20263 updates tracked since enumeration

NPPES CertifiedAugust 28, 2026

✔ NPI 1629625546 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 · 5601009625

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.

3601 W 13 MILE RD, Royal Oak, MI 48073

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Other Names 1

Former Name (1)Jaclyn Renee Dibartolomeo Pa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include McLaren Health Plan Community, Priority Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaclyn Renee Withrow Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123359288

PECOS Enrollment IDI20191004000280

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

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, MI

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230130

Location3601 W Thirteen Mile RdRoyal Oak, MI 48073 · Oakland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48073 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 20

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

AMIT BAHL MD, MPH

Emergency Medicine

3601 W 13 MILE RD, WILLIAM BEAUMONT HOSPITAL
ROYAL OAK, MI 48073

Oakland County (248) 898-0575

CATHERINE LEE PA

Physician Assistant