Individual provider Active NPI

Michael Jonczyk, M.D.

  • General Acute Care Hospital
  • Deerfield Beach, FL
National Provider Identifier
1285084384
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
268618 Issued in MA
Practice address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone
(954) 848-8137
NPI assigned
Jun 20, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X TRN39771 FL
General Acute Care Hospital 282N00000X 268618 MA Primary

Addresses

Primary practice location

201 E Sample Rd
Deerfield Beach, FL 33064-3502

Mailing address

3 Emerson LN
Middleton, MA 01949-2000

Other practice location 1

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200910001949 MA Practitioner - Internal Medicine 6901192772 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN39771FLMDGeneral Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Metro West Rehab Corp CurrentSince Sep 4, 2020 Accepting new patients
Metro West Rehab Corp CurrentSince Sep 4, 2020 Accepting new patients
Hebrew Seniorlife Affiliated Medical Group Inc CurrentSince Aug 15, 2020 Accepting new patients

Locations

1200 Centre St
Roslindale, MA 02131
Phone (617) 363-8000

150 Flanders Rd
Westborough, MA 01581
Phone (508) 870-2222

Organizations & group practices 3

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1285084384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 EMERSON LN",
            "city": "MIDDLETON",
            "state": "MA",
            "postal_code": "019492000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-848-8137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONCZYK",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "TRN39771",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "268618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.