Jacqueline Marie Chirco, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101013502 Issued in MI

Practice address

7020 Gateway Park Dr
Clarkston, MI 48346-2574

Phone

(248) 707-2781

Fax

(248) 455-7083

NPI assigned

Nov 9, 2006

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2022 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1023189487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 GATEWAY PARK DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462574",
            "telephone_number": "248-707-2781",
            "fax_number": "248-455-7083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7020 GATEWAY PARK DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462574",
            "telephone_number": "248-707-2781",
            "fax_number": "248-455-7083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRCO",
        "first_name": "JACQUELINE",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101013502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.