Individual provider Active NPI

Jeffrey James Mandziuk II, PA-C

  • Medical Physician Assistant
  • Flint, MI
National Provider Identifier
1316763204
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601013246 Issued in MI
Practice address
1 Hurley PLZ
Flint, MI 48503-5993
Phone
(810) 262-9000
NPI assigned
Nov 25, 2024
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601013246 MI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5993

Mailing address

259 Mack Ave # 2590
Detroit, MI 48201-2427

Other names 1

  • Mr. JJ Mandziuk II Other name

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
I20250825001302 MI Practitioner - Physician Assistant 3072013903 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hurley Medical CenterGroup PAC ID 2961308481, 336 clinicians

Practice addresses (Care Compare)

1 Hurley Plasa
9W Hurley Maternal Fetal Medicine
Flint, MI 48503-5902
Phone (810) 262-4787

1 Hurley PLZ
Flint, MI 48503-5902

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Aug 14, 2025 Accepting new patients
Hurley Medical Center Current Accepting new patients
Hurley Medical Center CurrentSince Aug 14, 2025 Accepting new patients
Pathology Associates Inc PC Current Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1 Hurley Plz
#4E
Flint, MI 48503
Phone (810) 262-9020

1 Hurley Plz
Ste Ed
Flint, MI 48503

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, 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": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1316763204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 MACK AVE # 2590",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035993",
            "telephone_number": "810-262-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDZIUK",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601013246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JJ",
            "last_name": "MANDZIUK",
            "prefix": "MR.",
            "suffix": "II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.