Individual provider Active NPI

Joseph Mashni, FNP

  • Nurse Practitioner
  • Watervliet, MI
National Provider Identifier
1265424527
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704141572 Issued in MI
Practice address
460 Medical Park Dr Ste 200
Watervliet, MI 49098-9225
Phone
(269) 463-3600
Fax
(269) 463-8206
NPI assigned
Aug 22, 2005
Last updated
Aug 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 47-04-141572 MI
Nurse Practitioner 363L00000X 4704141572 MI Primary

Addresses

Primary practice location

460 Medical Park Dr Ste 200
Watervliet, MI 49098-9225

Mailing address

460 Medical Park Dr Ste 200
Watervliet, MI 49098-9225
Phone (269) 463-3600

Other practice location 1

310 S Front St
Dowagiac, MI 49047-1740
Phone (269) 782-8696

Other identifiers 5

IdentifierTypeStateIssuer
104208714MedicaidMI
104208690MedicaidMI
104208705MedicaidMI
104208723MedicaidMI
140294150MedicaidMI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100521000384 MI Practitioner - Nurse Practitioner 1759439441 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Community Hospital WatervlietGroup PAC ID 7416942750, shared by 7 NPIs, 66 clinicians

Practice addresses (Care Compare)

400 Medical Park Dr
Watervliet, MI 49098-9225
Phone (269) 463-3600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Community Hospital Watervliet Current Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 23, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 23, 2022 Accepting new patients
Lakeland Medical Practices CurrentSince Oct 18, 2022 Accepting new patients
Lakeland Community Hospital Watervliet CurrentSince Oct 23, 2022 Accepting new patients
Lakeland Medical Practices CurrentSince Oct 18, 2022 Accepting new patients
Lakeland Community Hospital Watervliet PastSince Aug 27, 2023 Accepting new patients
Borgess Lee Memorial Hospital Past Accepting new patients

Locations

420 W High St
Dowagiac, MI 49047
Phone (269) 782-8681

520 Main St
Dowagiac, MI 49047
Phone (269) 390-0536

520 Main St
Ste A
Dowagiac, MI 49047
Phone (269) 783-3052

2002 S 11th St
Niles, MI 49120
Phone (269) 687-0200

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

5515 Cleveland Ave
Ste 5
Stevensville, MI 49127
Phone (269) 429-9644

400 Medical Park Dr
Watervliet, MI 49098
Phone (269) 463-3111

460 Medical Park Dr
Ste 200
Watervliet, MI 49098

Interoperability endpoints

  • FHIR API: https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/R4/
  • Direct secure messaging: jmashni1270723@epic00.corewelldirect.org

Organizations & group practices 9

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1265424527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MEDICAL PARK DR STE 200",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-463-3600",
            "fax_number": "269-463-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MEDICAL PARK DR STE 200",
            "city": "WATERVLIET",
            "state": "MI",
            "postal_code": "490989225",
            "telephone_number": "269-463-3600",
            "fax_number": "269-463-8206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 S Front St",
            "address_purpose": "LOCATION",
            "city": "Dowagiac",
            "state": "MI",
            "postal_code": "490471740",
            "country_code": "US",
            "telephone_number": "269-782-8696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASHNI",
        "first_name": "JOSEPH",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "47-04-141572",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704141572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104208714",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104208690",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104208705",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104208723",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140294150",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watervliet, MI

Sources for this page

Verify at the official NPI Registry.