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

Jeremiah Bacalso Ducusin, PA-C

Individual provider Medical Physician Assistant · NPI 1164173001

Jeremiah Bacalso Ducusin, PA-C is a Medical Physician Assistant in Clinton Township, Michigan. Works from 2 locations. Registered with an NPI since 2022.

In the registry since
2022
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 →

Practice location Address checks out

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone: (586) 263-2300
Show map & directions

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

Additional practice locations (1)

  • 468 Cadieux Rd, Grosse Pointe, MI 48230-1507 — (313) 473-1000

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1164173001
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 12, 2022
Last updated in NPPESJanuary 12, 2022
Certification dateJanuary 12, 2022

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