Organization Active NPI

Rehabilitation Associates of Midmichigan P L C

  • Physical Medicine & Rehabilitation Physician
  • Midland, MI
National Provider Identifier
1558433136
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
REHABILITATION ASSOCIATES OF MIDMICHIGAN P L C
Practice address
555 W Wackerly St
#3825
Midland, MI 48640-4722
Phone
(989) 631-9267
Fax
(989) 839-0629
NPI assigned
Nov 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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

Authorized official

Name
John A Szajenko, M DNPI 1881670362
Title
Owner
Phone
(989) 631-9267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MI Primary

Addresses

Primary practice location

555 W Wackerly St
#3825
Midland, MI 48640-4722

Mailing address

555 W Wackerly St
#3825
Midland, MI 48640-4722
Phone (989) 631-9267

Other identifiers 2

IdentifierTypeStateIssuer
3383068MedicaidMI
4187893MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090313000030 MI Part B Supplier - Clinic/Group Practice 3173689320 Receives reassigned benefits from 2 practitioners
Practice locations: Midland, MI

National Provider Directory

National Provider Directory

Locations

555 W Wackerly St
Ste 3825
Midland, MI 48640
Phone (517) 631-9267

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372291200000",
    "number": "1558433136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "#3825",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404722",
            "telephone_number": "989-631-9267",
            "fax_number": "989-839-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W WACKERLY ST",
            "address_2": "#3825",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404722",
            "telephone_number": "989-631-9267",
            "fax_number": "989-839-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION ASSOCIATES OF MIDMICHIGAN P L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2013-06-27",
        "status": "A",
        "authorized_official_last_name": "SZAJENKO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-631-9267",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3383068",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4187893",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2013; 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.