Anita Irene Charochak, D.O.

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

5101010442 Issued in MI

Practice address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Phone

(616) 252-7200

Fax

(616) 252-6239

NPI assigned

Jun 2, 2005

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI, FL2 enrollments

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 2

Specialty

Critical Care (Intensivists)

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231
• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223
• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062
  Medicare reassignment Care Compare group
• Covenant Medical Center, Inc.

  dba Covenant HealthCare

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment NPD
• Metropolitan Hospital

  dba Metro Health Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• Appleton Intensivist Group, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Ocala, FL
  • NPI 1407411796
  Medicare reassignment NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376

  Internal Medicine

  NPD
• Covenant Medical Center, Inc.

  dba Covenant Healthcare

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1588656946
  NPD
• Hospital Health Care Inc.

  dba Clarkston Primary Care

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1609970359
  NPD (past)
• Inpatient Consultants of Michigan PC

  • Hospitalist Physician
  • Livonia, MI
  • NPI 1861442824

  Internal Medicine

  NPD (past)

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

• Fort Walton Beach Medical Center, Inc.

  dba HCA Florida Fort Walton-Destin Hospital

  • General Acute Care Hospital
  • Fort Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation
• Okaloosa Hospital Inc

  dba HCA Florida Twin Cities Hospital

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation
• West Florida Regional Medical Center, Inc.

  dba HCA Florida West Hospital

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1639116726
  Care Compare affiliation

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1760484869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "address_2": "MEDICAL ADMINISTRATION",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-7200",
            "fax_number": "616-252-6239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1521 Gull Rd",
            "address_2": "Dept of Critical Care Medicine",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490481640",
            "country_code": "US",
            "telephone_number": "269-226-5348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAROCHAK",
        "first_name": "ANITA",
        "middle_name": "IRENE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-02",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101010442",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13558",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "OS13558",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101010442",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "5101010442",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4846754",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "AC010442",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CPIN #",
            "identifier": "70-0-F32947-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Stephen Cesarz
• Steven F Challa, DPM
• Tandy Champion, DO
• Hamzeh Charafeddine, DDS
• Emeline Charette
• Tatyana S Chatman
• Cherinova Essentials LLC
• Cherry Street Services Inc (Godwin Heights Middle School)
• Cherry Street Services Inc (Wyoming Community Health Center)
• Cherry Street Services Inc (Wyoming Junior High School Health Center)

• Critical Care Medicine (Internal Medicine) Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Critical Care Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.