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

Jakob Pankonin

Individual provider Physician Assistant · NPI 1063395747

Jakob Pankonin is a Physician Assistant in Mt Pleasant, Michigan. Qualified in 2025, 1 year ago. Practices as a sole proprietor.

Years since qualifying
1
In the registry since
2025

Practice location Address checks out

2480 Rosewood N
Mt Pleasant, MI 48858-5003
Phone: (989) 775-3823
Fax: (810) 275-0307
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1063395747
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 29, 2025
Last updated in NPPESMarch 24, 2026
Certification dateMarch 24, 2026
Mailing address2480 Rosewood N, Mt Pleasant, MI 48858-5003

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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