Stanislaw P Dajczak, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

35085114 Issued in OH

Practice address

1250 Ralston Ave
Suite 102
Defiance, OH 43512-5311

Phone

(419) 783-6996

Fax

(419) 782-8062

NPI assigned

Aug 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in OH

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.

Enrollment records 1

Specialty

Orthopedic SurgeryAlso: Sports Medicine

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Specialty Physicians of Blanchard Valley LLCGroup PAC ID 2668547613, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Blanchard Valley Hospital Hospital, Findlay, OH, CCN 360095
• Bluffton Hospital Hospital, Bluffton, OH, CCN 361322

Merit-based Incentive Payment System (MIPS)

Final score

71.66 of 100Reported as group

Quality

52.4

Promoting interoperability

84

Improvement activities

40

Cost

66.45

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Specialty Physicians of Blanchard Valley LLC

  • Cardiovascular Disease Physician
  • Findlay, OH
  • NPI 1689835415

  Orthopaedic Surgery

  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Blanchard Valley Regional Health Center

  • General Acute Care Hospital
  • Findlay, OH
  • NPI 1710920327
  Care Compare affiliation
• Blanchard Valley Regional Health Center

  • Critical Access Hospital
  • Bluffton, OH
  • NPI 1831137827
  Care Compare affiliation

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1104819705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 102",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-783-6996",
            "fax_number": "419-782-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 102",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-783-6996",
            "fax_number": "419-782-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAJCZAK",
        "first_name": "STANISLAW",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35085114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000362612",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5598615",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHC",
            "identifier": "04648",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "PO0192953",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "17-98831",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2542001",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "P00192953",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alesha Nicole Critten, LSW
• Kendra L Cross, MSN, APRN, FNP
• Matthew Cross
• Sarah Crowl
• Yvonne T Cusac, LSW
• Douglas Gregory Daoust, R.PH.
• Melissa Davies, PSYD
• Amanda Davila
• Dara C Davis
• Dashaun P Davis

• Orthopaedic Surgery Physician in Defiance, OH
• Providers in Defiance, OH by specialty
• Orthopaedic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.