Individual provider Active NPI

James Daniel Bozyk II, PA

  • Physician Assistant
  • Saint Joseph, MI
National Provider Identifier
1699403238
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
183 Peace Blvd
Saint Joseph, MI 49085-9146
Phone
(269) 428-3500
NPI assigned
Aug 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

183 Peace Blvd
Saint Joseph, MI 49085-9146

Mailing address

183 Peace Blvd
Saint Joseph, MI 49085-9146
Phone (269) 428-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL EPIC Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221119000222 MI Practitioner - Physician Assistant 0648648865 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

1234 Napier Ave
Saint Joseph, MI 49085-2112
Phone (269) 983-8300

31 N Saint Joseph Ave
Niles, MI 49120-2207
Phone (269) 687-1436

3950 Hollywood Rd
Saint Joseph, MI 49085-9151

6 Longmeadow Village Dr
Suite 1
Niles, MI 49120-7810
Phone (269) 408-1115

Hospital & facility affiliations

  • Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Medical Practices CurrentSince Aug 7, 2023 Accepting new patients

Locations

6 Longmeadow Village Dr
Ste 1
Niles, MI 49120
Phone (269) 684-3028

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

Interoperability endpoints

  • Direct secure messaging: jbozyk1268648@epic00.shdirect.org

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1699403238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 PEACE BLVD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859146",
            "telephone_number": "269-428-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 PEACE BLVD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859146",
            "telephone_number": "269-428-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZYK",
        "first_name": "JAMES",
        "middle_name": "DANIEL",
        "name_suffix": "II",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "183 Peace Blvd",
            "city": "Saint Joseph",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490859146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

Verify at the official NPI Registry.