Individual provider Active NPI

John Patrick Ockenfels, D.O.

  • Family Medicine Physician
  • Sault Sainte Marie, MI
National Provider Identifier
1457353633
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
JO010103 Issued in MI
Practice address
560 Osborn Blvd
Sault Sainte Marie, MI 49783-1961
Phone
(906) 632-1800
Fax
(906) 632-2199
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X JO010103 MI Primary

Addresses

Primary practice location

560 Osborn Blvd
Sault Sainte Marie, MI 49783-1961

Mailing address

560 Osborn Blvd
Sault Sainte Marie, MI 49783-1961
Phone (906) 632-1800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061211000291 MI Practitioner - Family PracticePractitioner - Emergency Medicine 9830188929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Michigan State University College of Osteopathic Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mymichigan Medical Center SaultGroup PAC ID 7315936481, 101 clinicians

Practice addresses (Care Compare)

500 Osborn Blvd
Sault S Marie, MI 49783-1822
Phone (906) 635-4460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
JO010103MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Sault Family Medicine CurrentSince Jul 1, 2006 Accepting new patients
Mymichigan Medical Center Sault Current Accepting new patients
Mymichigan Medical Center Sault CurrentSince Jul 1, 2006 Accepting new patients
Mymichigan Medical Center Sault Past Accepting new patients

Locations

4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956

500 Osborn Blvd
Sault South Marie, MI 49783
Phone (906) 635-4350

Interoperability endpoints

  • Direct secure messaging: jockenfels145796@mymichiganhealth.midirect.net

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 4

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345680000000",
    "number": "1457353633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831961",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 OSBORN BLVD",
            "city": "SAULT SAINTE MARIE",
            "state": "MI",
            "postal_code": "497831961",
            "telephone_number": "906-632-1800",
            "fax_number": "906-632-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCKENFELS",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2012-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "JO010103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sault Sainte Marie, MI

Sources for this page

Verify at the official NPI Registry.