Individual provider Active NPI

Wojciech Marek Roczniak, MD

  • Family Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1184205130
Registry record updated Aug 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME168621 Issued in FL
Practice address
1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564
Phone
(772) 398-1800
NPI assigned
Apr 20, 2021
Last updated
Aug 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME168621 FL Primary

Addresses

Primary practice location

1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564

Mailing address

1651 SE Tiffany Ave
Port St Lucie, FL 34952-7564
Phone (772) 398-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240821002344 FL Practitioner - Family Practice 3678011616 Reassigns benefits to 1 organization
I20241125000036 NY Practitioner - Family Practice 3678011616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1651 SE Tiffany Ave
Port Saint Lucie, FL 34952-7500
Phone (772) 223-5665

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Memorial Medical Center Inc CurrentSince Jan 1, 2025 Accepting new patients
Ellis Hospital CurrentSince Aug 24, 2024 Accepting new patients

Locations

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

1101 Nott St
#3754
Schenectady, NY 12308

600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000

624 McClellan St
Ste 101
Schenectady, NY 12304
Phone (518) 347-5043

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1618876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723334400000",
    "number": "1184205130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-398-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-398-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCZNIAK",
        "first_name": "WOJCIECH",
        "middle_name": "MAREK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME168621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.