Vernon Everett Dencklau, DO

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

5101007542 Issued in MI

Practice address

1107 Stone St
Suite 1
Port Huron, MI 48060-3569

Phone

(810) 989-6113

Fax

(810) 989-6117

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

Yes

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

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

Vascular SurgeryAlso: General Surgery, Thoracic Surgery

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Home Health Home health agency, Clinton Township, MI, CCN 237172
• McLaren Port Huron Hospital, Port Huron, MI, CCN 230216

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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 and National Provider Directory roles.

• McLaren Port Huron

  dba Port Huron Hospital Physician GRP

  • Psychiatry Physician
  • Port Huron, MI
  • NPI 1386888170
  Medicare reassignment Care Compare group NPD
• McLaren Port Huron

  • Family Medicine Physician
  • Port Huron, MI
  • NPI 1619355930
  NPD
• St Clair Cardiovascular Surgeons PLC

  • Cardiovascular Disease Physician
  • Roseville, MI
  • NPI 1194714980
  NPD (past)
• St. Clair Cardiovascular Surgeons, PLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Port Huron, MI
  • NPI 1922275312
  NPD (past)

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

• McLaren Health Management Group

  dba McLaren Home Health

  • Home Health Agency
  • Clinton TWP, MI
  • NPI 1609989805
  Care Compare affiliation
• McLaren Port Huron

  • General Acute Care Hospital
  • Port Huron, MI
  • NPI 1982685384
  Care Compare affiliation

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1821087453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 STONE ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603569",
            "telephone_number": "810-989-6113",
            "fax_number": "810-989-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 STONE ST",
            "address_2": "SUITE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603569",
            "telephone_number": "810-989-6113",
            "fax_number": "810-989-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENCKLAU",
        "first_name": "VERNON",
        "middle_name": "EVERETT",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "5101007542",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "5101007542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Sue Delange, LMSW
• Lynn Elizabeth Delicruz
• Rasha Demashkieh
• Walid Demashkieh, M.D.
• Brandi Demetroff
• Jeffrey William Lewis Dent, PA
• Tonya Marie Denton, LLMSW
• Megan Destefanis, RN
• Sumanpreet Dhaliwal, MD
• Kari Ann Diaz, LLPC

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.