Individual provider Active NPI

Michael Patrick Jajuga, D.C., C.C.S.P.

  • Chiropractor
  • Toledo, OH
National Provider Identifier
1346247673
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC.1699 Issued in OH
Practice address
1515 S Byrne Rd
Suite 106
Toledo, OH 43614-3458
Phone
(419) 389-1721
NPI assigned
Jul 1, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005740 MI
Chiropractor 111N00000X DC.1699 OH Primary

Addresses

Primary practice location

1515 S Byrne Rd
Suite 106
Toledo, OH 43614-3458

Mailing address

1515 S Byrne Rd Ste 106
Toledo, OH 43614-3459
Phone (419) 389-1721

Other identifiers 2

IdentifierTypeStateIssuer
3133969MedicaidMI
0977671MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111230000280 OH Practitioner - Chiropractic 8628244332 Practice locations: Toledo, OH

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1515 S Byrne Rd
Toledo, OH 43614-3459
Phone (419) 389-1721

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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1346247673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S BYRNE RD STE 106",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143459",
            "telephone_number": "419-389-1721",
            "fax_number": "419-389-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S BYRNE RD",
            "address_2": "SUITE 106",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436143458",
            "telephone_number": "419-389-1721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAJUGA",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C., C.C.S.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005740",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC.1699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3133969",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0977671",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.