Stephen M Jendzejec, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1287 Issued in ME

Practice address

127 Long Sands Rd
Suite 11
York, ME 03909-1158

Phone

(207) 363-8430

Fax

(207) 351-3006

NPI assigned

Apr 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 17

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• York Hospital

  • General Acute Care Hospital
  • York, ME
  • NPI 1376528398

  Family Medicine

  Medicare reassignment NPD
• York Family Practice

  • Family Medicine Physician
  • York, ME
  • NPI 1588713218
  NPD (past) Authorized official
• Seacoast Pathology Inc

  • Clinical Medical Laboratory
  • Exeter, NH
  • NPI 1154651230
  NPD

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302566400000",
    "number": "1447213939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 LONG SANDS RD",
            "address_2": "SUITE 11",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091158",
            "telephone_number": "207-363-8430",
            "fax_number": "207-351-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 LONG SANDS RD",
            "address_2": "SUITE 11",
            "city": "YORK",
            "state": "ME",
            "postal_code": "039091158",
            "telephone_number": "207-363-8430",
            "fax_number": "207-351-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENDZEJEC",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2011-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "1287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "010467585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NONHMO GROUP",
            "identifier": "596163",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080140515",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "3646359",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "MM2427",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "010467585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS NEW HAMPSHIRE",
            "identifier": "0405236YPME01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMECARE MEDICAID",
            "identifier": "283840099",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO GROUP",
            "identifier": "596163",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "E10019",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NONHMO",
            "identifier": "010467585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS NEW HAMPSHIRE",
            "identifier": "YORK083565",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STANDARD TAX ID",
            "identifier": "010467585",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283840099",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "003689",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MACHIGONNE",
            "identifier": "010467585",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "010467585001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Michelle Ives, DPT
• Heidi Joan Jacobsen, MS, LMHC M-CAP, LCPC
• Darcy James, SLP
• Holly Brunner James, NP
• Janie J. Gendron, LCSW, PLLC
• Ashley Jennings, M.D.
• JM Dental PC (York Family Dental)
• John Spero D.M.D., LLC (Atlantic Dental Associates)
• Mary Samantha Jones, M.D.
• Michael Harrison Jones, PHARMD

• Family Medicine Physician in York, ME
• Providers in York, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.