Individual provider Active NPI

James Ivan Matchynski

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1245083559
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Phone
(734) 764-1817
Fax
(734) 655-2911
NPI assigned
Apr 8, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Mailing address

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

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
I20240719000309 MI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9436695053

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1245083559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36475 FIVE MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481541971",
            "telephone_number": "734-655-4800",
            "fax_number": "734-655-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-764-1817",
            "fax_number": "734-655-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCHYNSKI",
        "first_name": "JAMES",
        "middle_name": "IVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.