Organization Active NPI

Michael J Jurenovich Dopc

  • Specialist
  • Greenville, PA
National Provider Identifier
1205848744
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
34.003706 Issued in OH
Legal business name
MICHAEL J JURENOVICH DOPC
Practice address
59 W Main St Ste B
Greenville, PA 16125-2449
Phone
(724) 588-4805
Fax
(724) 588-4809
NPI assigned
Aug 13, 2006
Last updated
Sep 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Authorized official

Name
Michael J Jurenovich, DONPI 1073504692
Title
Pres
Phone
(724) 588-4805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 34.003706 OH Primary

Addresses

Primary practice location

59 W Main St Ste B
Greenville, PA 16125-2449

Mailing address

59 W Main St Ste B
Greenville, PA 16125-2449
Phone (724) 588-4805

Other practice location 1

654 Youngstown Warren Rd
Niles, OH 44446-4356
Phone (724) 588-4805

Other identifiers 1

IdentifierTypeStateIssuer
0012030900001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100720000914 OH Part B Supplier - Clinic/Group Practice 8820019177 Receives reassigned benefits from 1 practitioner
Practice locations: Niles, OH
O20100817000035 PA Part B Supplier - Clinic/Group Practice 8820019177 Receives reassigned benefits from 1 practitioner
Practice locations: Greenville, PA

National Provider Directory

National Provider Directory

Locations

59 W Main St
#B
Greenville, PA 16125
Phone 7245884805109

59 W Main St
#Bm
Greenville, PA 16125
Phone (724) 588-4805

59 W Main St
Ste B
Greenville, PA 16125
Phone (724) 588-4805

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1205848744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 W MAIN ST STE B",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252449",
            "telephone_number": "724-588-4805",
            "fax_number": "724-588-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 W MAIN ST STE B",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252449",
            "telephone_number": "724-588-4805",
            "fax_number": "724-588-4809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "654 Youngstown Warren Rd",
            "address_purpose": "LOCATION",
            "city": "Niles",
            "state": "OH",
            "postal_code": "444464356",
            "country_code": "US",
            "telephone_number": "724-588-4805",
            "fax_number": "724-588-4809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL J JURENOVICH DOPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "JURENOVICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "724-588-4805",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "34.003706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012030900001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.