Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jaclyn Renee Dibartolomeo, PA-C

Individual provider Physician Assistant · NPI 1629625546

Jaclyn Renee Dibartolomeo, PA-C is a Physician Assistant in Troy, Michigan. Qualified in 2019, 7 years ago. Practices with Beaumont Medical Group Hospital Based Services, a 572-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
7
Licensed in
MI
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

44201 Dequindre Rd
Troy, MI 48085-1117
Phone: (248) 964-4866
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601009625 (MI)

Record details

NPI number1629625546
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 26, 2019
Last updated in NPPESDecember 29, 2020
Certification dateDecember 29, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Beaumont Medical Group Hospital Based Services — 572 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Troy