Michael E. Stachecki, M.D., P.L.L.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301058225 Issued in MI

Legal business name

MICHAEL E. STACHECKI, M.D., P.L.L.C.

Practice address

5885 S Main St
Suite 3
Clarkston, MI 48346-2981

Phone

(248) 620-1720

Fax

(248) 620-1740

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael E Stachecki, M.D.NPI 1659345056

Title

Owner--Managing Agent

Phone

(248) 620-1720

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael E Stachecki, M.D

  • Internal Medicine Physician
  • Clarkston, MI
  • NPI 1659345056
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1508992041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5885 S MAIN ST",
            "address_2": "SUITE 3",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462981",
            "telephone_number": "248-620-1720",
            "fax_number": "248-620-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5885 S MAIN ST",
            "address_2": "SUITE 3",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462981",
            "telephone_number": "248-620-1720",
            "fax_number": "248-620-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL E. STACHECKI, M.D., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "STACHECKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER--MANAGING AGENT",
        "authorized_official_telephone_number": "248-620-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301058225",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301058225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.