Joseph Dedvukaj, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4351048366 Issued in MI

Practice address

718 N Macomb St
Monroe, MI 48162-7815

Phone

(734) 240-8400

NPI assigned

May 20, 2021

Last updated

Jun 29, 2021By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: jdedvukaj695858@direct.hfhs.org
• Direct secure messaging: jdedvukaj789086@direct.shands.ufl.edu
• Direct secure messaging: joseph.dedvukaj.1@25394.direct.athenahealth.com

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1811562176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 BEACONSFIELD AVE APT 2N",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 N MACOMB ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481627815",
            "telephone_number": "734-240-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDVUKAJ",
        "first_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4351048366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dearborn Physical Therapy LTD. (Advanced Physical Therapy)
• Dearborn Physical Therapy LTD. (Advanced Physical Therapy (Monroe))
• Abigal Marie Deboard
• Deborah Fry
• Georgiana Alberta Declercq, RN
• Aaron Deen, CNP
• Jessica Degg
• Zeinab Dehghani, MD
• James Michael Dehring III
• Samantha Anne Deland

• General Practice Physician in Monroe, MI
• Providers in Monroe, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.