Individual provider Active NPI

Slawomir Mark Fratczak, MD

  • Internal Medicine Physician
  • Canton, OH
National Provider Identifier
1124009436
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35073829F Issued in OH
Practice address
1330 Mercy Dr NW
Suite 510
Canton, OH 44708-2626
Phone
(330) 580-4706
Fax
(330) 580-4707
NPI assigned
Nov 14, 2005
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35073829F OH Primary

Addresses

Primary practice location

1330 Mercy Dr NW
Suite 510
Canton, OH 44708-2626

Mailing address

1330 Mercy Dr NW
Suite 510
Canton, OH 44708-2626
Phone (330) 580-4706

Other identifiers 1

IdentifierTypeStateIssuer
2140749MedicaidOH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050512000506 OH Practitioner - Internal Medicine 2769423466 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.23 of 100Reported as group
Quality
83.64
Promoting interoperability
100
Improvement activities
40
Cost
73.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sinclair Physician Services, LLC Internal Medicine CurrentSince Mar 18, 2024 Accepting new patients
Hisey Physician Services, LLC Internal Medicine CurrentSince May 1, 2024 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Upper Valley Professional Corporation Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Aug 1, 2022 Accepting new patients
Mvhe Inc Internal Medicine Current Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1124009436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW",
            "address_2": "SUITE 510",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082626",
            "telephone_number": "330-580-4706",
            "fax_number": "330-580-4707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCY DR NW",
            "address_2": "SUITE 510",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082626",
            "telephone_number": "330-580-4706",
            "fax_number": "330-580-4707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRATCZAK",
        "first_name": "SLAWOMIR",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35073829F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2140749",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.