Individual provider Active NPI

James Joseph Macoviak, DDS

  • Dentist
  • Drums, PA
National Provider Identifier
1225047384
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS023630L Issued in PA
Practice address
Route 309
Rittenhouse Place B2
Drums, PA 18222-0456
Phone
(570) 788-7010
Fax
(570) 788-5188
NPI assigned
Aug 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS023630L PA Primary

Addresses

Primary practice location

Route 309
Rittenhouse Place B2
Drums, PA 18222-0456

Mailing address

PO Box 456
Rittenhouse Place
Drums, PA 18222-0456
Phone (570) 788-7010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20160510000963 PA Order and Referring Only - DentistPractitioner - Dentist 3476842709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225047384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 456",
            "address_2": "RITTENHOUSE PLACE",
            "city": "DRUMS",
            "state": "PA",
            "postal_code": "182220456",
            "telephone_number": "570-788-7010",
            "fax_number": "570-788-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 309",
            "address_2": "RITTENHOUSE PLACE B2",
            "city": "DRUMS",
            "state": "PA",
            "postal_code": "182220456",
            "telephone_number": "570-788-7010",
            "fax_number": "570-788-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACOVIAK",
        "first_name": "JAMES",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS023630L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Drums, PA

Sources for this page

Verify at the official NPI Registry.