Individual provider Active NPI

John Grgicak, D.C.

  • Chiropractor
  • Royal Oak, MI
National Provider Identifier
1528153103
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
JG008248 Issued in MI
Practice address
716 West 11 Mile Road
Royal Oak, MI 48067-2411
Phone
(248) 544-9009
Fax
(248) 544-9002
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X JG008248 MI Primary

Addresses

Primary practice location

716 West 11 Mile Road
Royal Oak, MI 48067-2411

Mailing address

716 West 11 Mile Road
Royal Oak, MI 48067-2411
Phone (248) 544-9009

Other names 1

  • Mr. John E Grgicak Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050621001118 MI Practitioner - Chiropractic 4082658455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Progressive Chiropractic Clinic PCGroup PAC ID 5092042069, 2 clinicians

Practice addresses (Care Compare)

716 W 11 Mile Rd
Royal Oak, MI 48067-2411
Phone (248) 544-9009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JG008248MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Butzin, Matoshko & Associates Chiropractic Clinics PLLC Chiropractor PastSince Jan 21, 2002 Accepting new patients
Butzin, Matoshko & Associates Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1528153103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 WEST 11 MILE ROAD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672411",
            "telephone_number": "248-544-9009",
            "fax_number": "248-544-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 WEST 11 MILE ROAD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672411",
            "telephone_number": "248-544-9009",
            "fax_number": "248-544-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRGICAK",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "JG008248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "GRGICAK",
            "middle_name": "E",
            "prefix": "MR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.