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WAYNE JOLLY PA-C
NPI 1679693436
Physician Assistant in Detroit, MI

Active since March 29, 2007PECOS Enrolled
4100 JOHN R ST, KARMANOS CANCER CENTER, DETROIT, MI 48201(800) 527-6266(313) 576-8381 Get Directions Write a Review

NPPES record last updated: October 25, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Wayne Jolly Pa-c NPPES

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

WAYNE JOLLY PA-C (NPI 1679693436) is an individual physician assistant in Detroit, Michigan, licensed in Michigan (5601001710) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679693436
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameWAYNE JOLLYCredential: PA-C
Location Address4100 JOHN R ST, KARMANOS CANCER CENTERDetroit, MI 48201-2013
Mailing Address1560 E Maple Rd, Suite 400-credentialingTroy, MI 48083-1138 · (800) 527-6266 · Fax (313) 576-8381
Phone(800) 527-6266
Fax(313) 576-8381
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateOctober 25, 2016
✔ NPI 1679693436 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 · 5601001710
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.
4100 JOHN R ST, Detroit, MI 48201
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wayne Jolly Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48201 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.

BARBARA ANN KARMANOS CANCER HOSPITAL
Pharmacy (Community/Retail Pharmacy)
4100 JOHN R ST, SUITE HP00RX
DETROIT, MI 48201
Wayne County (313) 576-9350
BARBARA ANN KARMANOS CANCER CENTER
General Acute Care Hospital
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-9345
UNIVERSITY INTERNAL MEDICINE SPECIALISTS
Internal Medicine (Medical Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-4525
ANDREA P SAMPSON-HAGGOOD N.P.
Nurse Practitioner
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 745-4525
KATHERINE BRECKENRIDGE SLP
Speech-Language Pathologist
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (800) 527-6266
KRISTEN MOERCHEN
Nurse Practitioner (Acute Care)
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 831-4038
DR. STEPHEN A KAURALA
Pharmacist
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-9815
ELIZABETH HAY PHARMD
Pharmacist (Oncology)
4100 JOHN R ST
DETROIT, MI 48201
Wayne County (313) 576-8807

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 Wayne Jolly's NPI number?

The NPI number for Wayne Jolly is 1679693436. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Wayne Jolly located?

Wayne Jolly practices at 4100 John R St Karmanos Cancer Center, Detroit, MI 48201. The listed phone number is (800) 527-6266.

What is Wayne Jolly's specialty?

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

Is Wayne Jolly enrolled in Medicare?

Yes. Wayne Jolly is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Wayne Jolly was last updated on October 25, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.