Thaddeus F Juszczak, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704106613 Issued in MI

Practice address

701 S Health Pkwy
Three Rivers, MI 49093-8352

Phone

(269) 278-1145

Fax

(269) 273-9611

NPI assigned

May 24, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1871548222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 S HEALTH PKWY",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-273-9789",
            "fax_number": "269-273-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 S HEALTH PKWY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938352",
            "telephone_number": "269-278-1145",
            "fax_number": "269-273-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSZCZAK",
        "first_name": "THADDEUS",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704106613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4893487-10",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP-THREE RIVERS HEALTH",
            "identifier": "700G560080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G51062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Elizabeth Jasiak, PT, DPT
• JCP 3 LLC
• Anna Jensen, PT, DPT
• Jason Richard Johnson, FNP
• Rebecca Allen Jones, ADULT NP
• K2A Counseling Services LLC
• Patricia A Kane, N.P.
• Samreen Kaur, FNP-C
• Jacob Keeler, LPC
• Hillary Elizabeth Keene

• Certified Registered Nurse Anesthetist in Three Rivers, MI
• Providers in Three Rivers, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.