Individual provider Active NPI

Jeffrey M. Kovacic, D.C.

  • Chiropractor
  • Hillsdale, MI
National Provider Identifier
1821094699
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
JK005923 Issued in MI
Practice address
1384 Vera Dr
Hillsdale, MI 49242-9823
Phone
(517) 437-4767
Fax
(517) 437-0567
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X JK005923 MI Primary

Addresses

Primary practice location

1384 Vera Dr
Hillsdale, MI 49242-9823

Mailing address

1384 Vera Dr
Hillsdale, MI 49242-9823
Phone (517) 437-4767

Other identifiers 7

IdentifierTypeStateIssuer
P00643696OtherMIPALMETTO RAILROAD GBA
1174771745OtherMITYPE II NPI
262968470OtherMICOFINITY
2650090OtherMICIGNA PPO
950C000040OtherMIBLUE CARE NETWORK
5843475OtherMIAETNA
950C000040OtherMIINDIVIDUAL BCBSM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081009000762 MI Practitioner - Chiropractic 7719055243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knapp Chiropractic Center PLLCGroup PAC ID 4183792609, 4 clinicians

Practice addresses (Care Compare)

1384 Vera Dr
Hillsdale, MI 49242-9823
Phone (517) 437-4656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JK005923MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Knapp Chiropractic Center PLLC Chiropractor CurrentSince Oct 1, 2008 Accepting new patients

Locations

1384 Vera Dr
Hillsdale, MI 49242
Phone (517) 437-4767

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1821094699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1384 VERA DR",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429823",
            "telephone_number": "517-437-4767",
            "fax_number": "517-437-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1384 VERA DR",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429823",
            "telephone_number": "517-437-4767",
            "fax_number": "517-437-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACIC",
        "first_name": "JEFFREY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "JK005923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RAILROAD GBA",
            "identifier": "P00643696",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NPI",
            "identifier": "1174771745",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COFINITY",
            "identifier": "262968470",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PPO",
            "identifier": "2650090",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "950C000040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5843475",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL BCBSM PIN",
            "identifier": "950C000040",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.