Individual provider Active NPI

Michael Joseph Mayerchak, DMD

  • Endodontics
  • Roanoke, VA
National Provider Identifier
1144315649
Registry record updated Mar 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
040142795 Issued in VA
Practice address
4102 Electric Rd
Roanoke, VA 24018-0614
Phone
(540) 772-9515
NPI assigned
Oct 3, 2006
Last updated
Mar 1, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 040142795 VA Primary

Addresses

Primary practice location

4102 Electric Rd
Roanoke, VA 24018-0614

Mailing address

6327 Juliet CT
Roanoke, VA 24018-7788
Phone (540) 400-7944

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131028001701 VA Practitioner - Oral Surgery 3274768221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
040142795VAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Okeef & Hinrichs DDS PC Past Accepting new patients
Swva Dental Specialists Endodontics PastSince Dec 21, 2021 Accepting new patients

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, 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362096000000",
    "number": "1144315649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6327 JULIET CT",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240187788",
            "telephone_number": "540-400-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 ELECTRIC RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240180614",
            "telephone_number": "540-772-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERCHAK",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2013-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "040142795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.