Derek Patrick Kaczor, D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010482 Issued in MI

Practice address

15175 S Dixie Hwy Ste a
Monroe, MI 48161-5038

Phone

(734) 244-4285

NPI assigned

Sep 30, 2016

Last updated

Nov 13, 2019By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adjusted Health Chiropractic PLLCGroup PAC ID 6507291614, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Adjusted Health Chiropractic PLLC

  • Chiropractor
  • Monroe, MI
  • NPI 1760044341
  Medicare reassignment Care Compare group Authorized official
• Heiserman Family Chiropractic LLC

  • Chiropractor
  • Dundee, MI
  • NPI 1063003010
  NPD

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1124577234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 PIN OAK CT",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481623391",
            "telephone_number": "470-262-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15175 S DIXIE HWY STE A",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481615038",
            "telephone_number": "734-244-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACZOR",
        "first_name": "DEREK",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-30",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP029240",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Monroe, MI
• Providers in Monroe, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.