Joyce K Vaclav DO PC

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

5101009390 Issued in MI

Legal business name

JOYCE K VACLAV DO PC

Practice address

25803 Dreschfield Ave
Grosse Ile, MI 48138-1602

Phone

(440) 934-6135

Fax

(440) 934-6147

NPI assigned

Jun 12, 2006

Last updated

Jan 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joyce K Vaclav, DONPI 1588664874

Title

Owner/Physician

Phone

(734) 558-8891

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joyce K Vaclav, DO

  • Infectious Disease Physician
  • Grosse Ile, MI
  • NPI 1588664874

  Hospitalist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1538101720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25803 DRESCHFIELD AVE",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481381602",
            "telephone_number": "440-934-6135",
            "fax_number": "440-934-6147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25803 DRESCHFIELD AVE",
            "city": "GROSSE ILE",
            "state": "MI",
            "postal_code": "481381602",
            "telephone_number": "440-934-6135",
            "fax_number": "440-934-6147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOYCE K VACLAV DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "VACLAV",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "734-558-8891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "5101009390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538101720",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4634734",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "E77788",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "00421",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1158211544",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "440H203220",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4634716",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD5444",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grosse Ile Urgent Care PC
• Beth Ann Hedke, ATC
• Island Compounding Pharmacy
• Carol Jaafar
• Deborah Joseph
• Amy L.S. Kapala
• Douglas John Kelley, D.O.
• Mounir Khaled, M.D.
• Sumera Khalid, DMD
• Isabella Kowal, RN

• Hospitalist Physician in Grosse Ile, MI
• Providers in Grosse Ile, MI by specialty
• Hospitalist Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.