MS. JESSICA MARIE TACCONELLI (PA-C) – Medical Physician Assistant, NPI 1164791752
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
6,069 PHYSICIAN ASSISTANT in MI
Provider Addresses for MS. JESSICA MARIE TACCONELLI (PA-C)
6330 ORCHARD LAKE RD.
SUITE 120
WEST BLOOMFIELD, MI 483226330
Phone: (248) 855-3366
Fax: (248) 855-6213
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 126 Open Payments records for all available years, with a total value of $2,342.
Total Amount is formed as General ($2,342) + Research ($0) + Ownership ($0) = $2,342.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($382).
Total Amount
$2,342
General + Research + Ownership
Payments
126
Total payment records
General Amount
$2,342
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $382 |
| SUN PHARMACEUTICAL INDUSTRIES INC. | $257 |
| GENZYME CORPORATION | $247 |
| Janssen Biotech, Inc. | $188 |
| Incyte Corporation | $101 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2014-03-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140320000758 | I | Physician Assistant | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 104 | 25 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 63 | 48 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 55 | 53 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 44 | 37 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 34 | 32 | $0 |
Insurance plans in this area (ZIP 48322)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | IN | |
| Physician Assistant | NC | |
| Physician Assistant | MI | |
| Micrographic Dermatologic Surgery (Mds), Dermatology | MI | |
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | MI | |
| Physician Assistant | MI | |
| D E R M A T O L O G Y | MI | |
| D E R M A T O L O G Y | MI |
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