Individual provider Active NPI

Monika Danuta Dedejczyk

  • Case Manager/Care Coordinator
  • Dublin, OH
National Provider Identifier
1205420510
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
525 Metro PL N Ste 300
Dublin, OH 43017-5320
Phone
(855) 289-1722
NPI assigned
Feb 26, 2021
Last updated
Aug 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X OH Primary
Peer Specialist 175T00000X NU

Addresses

Primary practice location

525 Metro PL N Ste 300
Dublin, OH 43017-5320

Mailing address

13275 Spruce Run Dr Apt 310
North Royalton, OH 44133-4282
Phone (440) 665-2829

Other practice location 1

13275 Spruce Run Dr Apt 310
North Royalton, OH 44133-4282
Phone (440) 665-2829

Other identifiers 2

IdentifierTypeStateIssuer
17500000MedicaidOH
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755475200000",
    "number": "1205420510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13275 SPRUCE RUN DR APT 310",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334282",
            "telephone_number": "440-665-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13275 Spruce Run Dr Apt 310",
            "address_purpose": "LOCATION",
            "city": "North Royalton",
            "state": "OH",
            "postal_code": "441334282",
            "country_code": "US",
            "telephone_number": "440-665-2829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDEJCZYK",
        "first_name": "MONIKA",
        "middle_name": "DANUTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17500000",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.