Provider Demographics
NPI:1639617673
Name:OCASIO, JOSEPH PAUL JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PAUL
Last Name:OCASIO
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:24963 REDDINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-8881
Mailing Address - Country:US
Mailing Address - Phone:440-670-8891
Mailing Address - Fax:
Practice Address - Street 1:777 KIMOLE LN STE 240
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1400
Practice Address - Country:US
Practice Address - Phone:517-263-9491
Practice Address - Fax:517-263-9591
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.004998RX363A00000X
MI5601008917363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0206854Medicaid