Individual provider Active NPI

Deborah Ann Mroczka, NP-C

  • Family Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1366956336
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704206849NSA17501 Issued in MI
Practice address
400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152
Phone
(517) 205-8991
NPI assigned
Nov 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704206849NSA17501 MI Primary

Addresses

Primary practice location

400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152

Mailing address

400 Hinckley Blvd Ste 100
Jackson, MI 49203-6152
Phone (517) 205-8991

Other practice location 1

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmroczka453695@direct.hfhs.org Direct

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
I20180620000614 MI Practitioner - Nurse Practitioner 1052666880 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

27931 C Dr N
Henry Ford Allegiance Family Medicine Ablio
Albion, MI 49224-8402
Phone (517) 205-2579

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704206849NSA17501MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Family CurrentSince May 25, 2018 Accepting new patients
Independent Emergency Physicians, P.C. CurrentSince Aug 27, 2018 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince May 25, 2018 Accepting new patients
Wa Foote Memorial Hospital, Inc Current Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

27931 C Dr N
Albion, MI 49224
Phone (517) 629-8311

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

1401 W North St
Jackson, MI 49202
Phone (517) 205-2555

400 Hinckley Blvd
Ste 100
Jackson, MI 49203
Phone (517) 205-8991

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Organizations & group practices 5

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.

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": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1366956336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036152",
            "telephone_number": "517-205-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HINCKLEY BLVD STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492036152",
            "telephone_number": "517-205-8991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-205-4800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MROCZKA",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704206849NSA17501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmroczka453695@direct.hfhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "400 Hinckley Blvd Ste 100",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492036152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.