Jamie Walderzak

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008828 Issued in MI

Practice address

815 N Clare Ave
Harrison, MI 48625-8176

Phone

(989) 539-4434

NPI assigned

Sep 20, 2018

Sex

Female

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

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mymichigan Medical Center ClareGroup PAC ID 7012829773, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mymichigan Medical Center Clare Hospital, Clare, MI, CCN 230180
• Mymichigan Medical Center Gladwin Hospital, Gladwin, MI, CCN 231325
• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwalderzak77297@mymichiganhealth.midirect.net

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.

• Mymichigan Medical Center Clare

  • General Practice Physician
  • Clare, MI
  • NPI 1134394026

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Mymichigan Medical Center Clare

  • Physical Therapist
  • Houghton Lake, MI
  • NPI 1548450133
  NPD (past)

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

• Mymichigan Medical Center Clare

  • General Acute Care Hospital
  • Clare, MI
  • NPI 1568414589
  Care Compare affiliation
• Mymichigan Medical Center Gladwin

  • Critical Access Hospital
  • Gladwin, MI
  • NPI 1235248071
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1881178465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 N CLARE AVE",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486258176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 N CLARE AVE",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486258176",
            "telephone_number": "989-539-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDERZAK",
        "first_name": "JAMIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Rescue Ambulance Authority
• United Rescue Service
• Phani Deepthi Vadlamudi, M.D.
• Deana Vanbuskirk, LMSW
• Melisa Catherine Wagner
• Shane William Walker, LLCMSW
• Wandering Minds Therapy Collective
• Jane Wasserman
• Sydnee Sue Waters
• Ashley Watters

• Physician Assistant in Harrison, MI
• Providers in Harrison, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.