Active NPI
Daniel J Cirka, PAC
- Physician Assistant
- Fenton, MI
National Provider Identifier
1619921913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601001234
- Practice address
- 305 N Leroy St
Fenton, MI 48430-2729 - Phone
- (810) 629-9200
- Fax
- (810) 629-9653
- NPI assigned
- May 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001234 | MI | Primary |
Addresses
Primary practice location
305 N Leroy St
Fenton, MI 48430-2729
Mailing address
305 N Leroy St
Fenton, MI 48430-2729
Phone (810) 629-0336
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601001234 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204761600000",
"number": "1619921913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 N LEROY ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302729",
"telephone_number": "810-629-0336",
"fax_number": "810-629-7251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 N LEROY ST",
"city": "FENTON",
"state": "MI",
"postal_code": "484302729",
"telephone_number": "810-629-9200",
"fax_number": "810-629-9653"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIRKA",
"first_name": "DANIEL",
"middle_name": "J",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-20",
"last_updated": "2008-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.