Individual provider Active NPI

Stefanee Jones, NP

  • Family Nurse Practitioner
  • Hamtramck, MI
National Provider Identifier
1124673215
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704284470 Issued in MI
Practice address
11410 Charest St
Hamtramck, MI 48212-3025
Phone
(313) 891-9473
Fax
(313) 892-1750
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704284470 MI Primary

Addresses

Primary practice location

11410 Charest St
Hamtramck, MI 48212-3025

Mailing address

11410 Charest St
Hamtramck, MI 48212-3025
Phone (313) 891-9473

Other names 1

  • Stefanee Dziwirski Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200420002372 MI Practitioner - Nurse Practitioner 5395175046 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704284470MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Jan 23, 2025 Accepting new patients
University Pediatricians PastSince Apr 20, 2021 Accepting new patients

Locations

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1124673215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 CHAREST ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123025",
            "telephone_number": "313-891-9473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 CHAREST ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482123025",
            "telephone_number": "313-891-9473",
            "fax_number": "313-892-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "STEFANEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704284470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEFANEE",
            "last_name": "DZIWIRSKI",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamtramck, MI

Sources for this page

Verify at the official NPI Registry.