Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Jacqueline Renee Lassen, PA-C

Individual provider Surgical Physician Assistant · NPI 1912215021

Miss. Jacqueline Renee Lassen, PA-C is a Physician Assistant in Detroit, Michigan. Qualified in 2006, 20 years ago. Practices with Vhs Physicians of Michigan, a 217-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
20
Licensed in
MI
In the registry since
2010
Specialties on file
2
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

4160 John R St Ste 615
Detroit, MI 48201-2022
Phone: (313) 745-5111
Fax: (313) 993-8669
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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 5601005878 (MI)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 5601005878 (MI)

Record details

NPI number1912215021
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 23, 2010
Last updated in NPPESNovember 20, 2024
Certification dateNovember 20, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Vhs Physicians Of Michigan — 217 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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