Individual provider Active NPI

Monika Joanna Pronczuk, D.M.D.

  • General Practice Dentistry
  • Marshfield, MA
National Provider Identifier
1447468491
Registry record updated Jul 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20049 Issued in MA
Practice address
892 Plain St Ste 5
Marshfield, MA 02050-2191
Phone
(781) 834-8969
Fax
(781) 834-0052
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20049 MA Primary

Addresses

Primary practice location

892 Plain St Ste 5
Marshfield, MA 02050-2191

Mailing address

892 Plain St Ste 5
Marshfield, MA 02050-2191
Phone (781) 834-8969

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160112000401 MA Order and Referring Only - DentistPractitioner - Dentist 2860794674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20049MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marshfield Dental Group PastSince Jul 27, 2020 Accepting new patients
Monika J. Pronczuk, DMD, PC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594944000000",
    "number": "1447468491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "892 PLAIN ST STE 5",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502191",
            "telephone_number": "781-834-8969",
            "fax_number": "781-834-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "892 PLAIN ST STE 5",
            "city": "MARSHFIELD",
            "state": "MA",
            "postal_code": "020502191",
            "telephone_number": "781-834-8969",
            "fax_number": "781-834-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRONCZUK",
        "first_name": "MONIKA",
        "middle_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, MA

Sources for this page

Verify at the official NPI Registry.