Dustin G Nowacek, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

4301092655 Issued in MI

Practice address

819 N Shiawassee St Ste 110
Owosso, MI 48867-1601

Phone

(989) 723-1390

Fax

(989) 725-1415

NPI assigned

Jun 4, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Michigan State University College of Human Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare Hospital, Owosso, MI, CCN 230121

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: d.nowacek@memorialhealthcare.midirect.net

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.

• Memorial Hospital

  • General Practice Physician
  • Owosso, MI
  • NPI 1235160532
  Medicare reassignment Care Compare group NPD
• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137

  Neurological Surgery

  Medicare reassignment NPD
• Regents of the University of Michigan

  • Internal Medicine Physician
  • Ann Arbor, MI
  • NPI 1205868353
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Memorial Hospital

  • General Practice Physician
  • Owosso, MI
  • NPI 1316008006

  Neurology

  NPD
• Memorial Hospital

  • Anesthesiology Physician
  • Owosso, MI
  • NPI 1659527737
  NPD
• Regents of the University of Michigan

  • Neurology Physician
  • Ann Arbor, MI
  • NPI 1053343004
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Memorial Hospital

  • Home Health Agency
  • Owosso, MI
  • NPI 1952498610
  NPD (past)

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

• Memorial Hospital

  • General Acute Care Hospital
  • Owosso, MI
  • NPI 1063414233
  Care Compare affiliation

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1699934604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 N SHIAWASSEE ST STE 110",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671601",
            "telephone_number": "989-723-1390",
            "fax_number": "989-725-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 N SHIAWASSEE ST STE 110",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671601",
            "telephone_number": "989-723-1390",
            "fax_number": "989-725-1415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4200 Fashion Square Blvd Ste 301",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486031375",
            "country_code": "US",
            "telephone_number": "989-729-4206",
            "fax_number": "989-729-4207",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Byron Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488431080",
            "country_code": "US",
            "telephone_number": "517-625-1046",
            "fax_number": "989-723-8098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWACEK",
        "first_name": "DUSTIN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301092655",
            "primary": true
        },
        {
            "code": "204R00000X",
            "taxonomy_group": "",
            "desc": "Electrodiagnostic Medicine",
            "state": "MI",
            "license": "4301092655",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301092655",
            "primary": false
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "MI",
            "license": "4301092655",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699934604",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger Paul Nichols
• Levi Alexander Nixon
• Shadoe S Nolph
• Ahmad-Reza Noroozi, DDS
• North Street Medical Center P C
• Kylie O'Brien
• Katie Louise O'Dell
• Patrick J O'Hara
• Oakland Orthopedic Appliances Inc
• Jennifer Oldham

• Neurology Physician in Owosso, MI
• Providers in Owosso, MI by specialty
• Neurology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.