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JACLYN RENEE DIBARTOLOMEO PA-C
NPI 1629625546
Physician Assistant in Troy, MI

Active since August 26, 2019PECOS EnrolledAccepts Medicare Assignment
44201 DEQUINDRE RD, TROY, MI 48085(248) 964-4866 Get Directions Write a Review

NPPES record last updated: December 29, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 29, 2020, Aug 26, 2019 (2 updates tracked since 2019).

About Jaclyn Renee Dibartolomeo Pa-c NPPES

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

JACLYN RENEE DIBARTOLOMEO PA-C (NPI 1629625546) is an individual physician assistant in Troy, 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 DIBARTOLOMEOCredential: PA-C
Location Address44201 DEQUINDRE RDTroy, MI 48085-1117
Mailing Address26901 Beaumont Blvd Ste 3dSouthfield, MI 48033-3849
Phone(248) 964-4866
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateAugust 26, 2019
Last NPPES UpdateDecember 29, 20202 updates tracked since enumeration
NPPES CertifiedDecember 29, 2020
✔ 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.
44201 DEQUINDRE RD, Troy, MI 48085
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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 Dibartolomeo 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 48085 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.

HARINI ERUPAKA REDDY M.D.
Pediatrics
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-1007
JOSLEEN ALBISHARA
Pharmacist
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-5000
STEPHANIE ANNE DAVENPORT PAC
Physician Assistant
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-4866
KRISTEN M LIGHT DNP, RN, AGPCNP-BC
Nurse Practitioner (Primary Care)
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-5000
ELLEN O MCGUIRE
Physician Assistant
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-4866
SAMANTHA GRACE HENDERSON PA-C
Physician Assistant
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-5000
DAVID DONALDSON
Emergency Medicine
44201 DEQUINDRE RD, EC
TROY, MI 48085
Oakland County (248) 964-8787
SHARON LINDOW
Speech-Language Pathologist
44201 DEQUINDRE RD
TROY, MI 48085
Oakland County (248) 964-5000

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 Jaclyn Dibartolomeo's NPI number?

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

Where is Jaclyn Dibartolomeo located?

Jaclyn Dibartolomeo practices at 44201 Dequindre Rd, Troy, MI 48085. The listed phone number is (248) 964-4866.

What is Jaclyn Dibartolomeo's specialty?

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

Is Jaclyn Dibartolomeo enrolled in Medicare?

Yes. Jaclyn Dibartolomeo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jaclyn Dibartolomeo accept?

Health plans from McLaren Health Plan Community and Priority Health list Jaclyn Dibartolomeo 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 Jaclyn Dibartolomeo affiliated with any hospitals?

According to CMS data, Jaclyn Dibartolomeo is affiliated with Beaumont Hospital Royal Oak.

When was this NPI record last updated?

The NPPES record for Jaclyn Dibartolomeo was last updated on December 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.