Individual provider Active NPI

Christopher Robert Hanczaruk, D.O.

  • Emergency Medicine Physician
  • Mount Clemens, MI
National Provider Identifier
1225497985
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101022203 Issued in MI
Practice address
1000 Harrington St
Mount Clemens, MI 48043-2920
Phone
(586) 493-8000
NPI assigned
Feb 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101022203 MI Primary

Addresses

Primary practice location

1000 Harrington St
Mount Clemens, MI 48043-2920

Mailing address

1 William Carls Dr
Commerce Township, MI 48382-2201
Phone (248) 937-3335

Other practice location 1

1 William Carls Dr
Commerce Township, MI 48382-2201
Phone (248) 937-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200324000223 MI Practitioner - Emergency Medicine 7911297833 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Marlette Regional Hospital Current Accepting new patients
Deckerville Community Hospital, Inc. Emergency Medicine CurrentSince Apr 27, 2025 Accepting new patients
Deckerville Community Hospital, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Hills & Dales General Hospital, Inc. Current Accepting new patients
Deckerville Community Hospital, Inc CurrentSince Apr 27, 2025 Accepting new patients

Locations

4675 Hill St
Cass City, MI 48726
Phone (989) 872-2121

3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835

2770 Main St
Marlette, MI 48453
Phone (989) 635-4000

Interoperability endpoints

  • Direct secure messaging: chanczaruk176986@direct.covenanthealthcare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225497985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3335",
            "fax_number": "248-937-5088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HARRINGTON ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432920",
            "telephone_number": "586-493-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 William Carls Dr",
            "address_purpose": "LOCATION",
            "city": "Commerce Township",
            "state": "MI",
            "postal_code": "483822201",
            "country_code": "US",
            "telephone_number": "248-937-3335",
            "fax_number": "248-937-5088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANCZARUK",
        "first_name": "CHRISTOPHER",
        "middle_name": "ROBERT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.