James Driscoll Gendernalik, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101017990 Issued in MI

Practice address

2500 Niles Rd Ste 1
2ND Floor
Saint Joseph, MI 49085-3225

Phone

(269) 429-5000

NPI assigned

Jun 19, 2007

Last updated

Feb 3, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Oct 1, 2018 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: jamesgendernalik@fpsjpc.allscriptsdirect.net

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1720283633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NILES RD STE 1",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853225",
            "telephone_number": "269-429-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NILES RD STE 1",
            "address_2": "2ND FLOOR",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853225",
            "telephone_number": "269-429-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDERNALIK",
        "first_name": "JAMES",
        "middle_name": "DRISCOLL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-19",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101017990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Elizabeth Gatt, PT, DPT
• Tara Gaul, LMT
• Gelesko Chiropractic PLLC
• Peter J Gelesko, DC
• Gleb Gregory Gendel, D.O
• Sarah Broski Gendernalik, DO
• Genesis Family Health Center, PLC
• Genesis Family Health Center, PLLC
• Alexander Bradley George, PA
• Don-Nee Elizabeth German, PHD

• Family Medicine Physician in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.