Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacob Mathew Mogg, PA-C

Individual provider Physician Assistant · NPI 1134804487

Jacob Mathew Mogg, PA-C is a Physician Assistant in Greenville, Michigan. Qualified in 2023, 3 years ago. Practices with Spectrum Health United, a 88-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1202 W Oak St
Greenville, MI 48838-2155
Phone: (616) 754-4685
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601012881 (MI)

Record details

NPI number1134804487
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 15, 2023
Last updated in NPPESApril 30, 2025
Certification dateApril 30, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Spectrum Health United — 88 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Greenville