Michelle Dawiczyk, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2808 Issued in CT

Practice address

34 Proffessional Park Rd
Storrs, CT 06268-1659

Phone

(860) 487-0002

Fax

(860) 429-1663

NPI assigned

Sep 17, 2012

Last updated

Sep 17, 2012By the provider in NPPES

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 ME

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: michelledawiczyk@wfamprac.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waterville Family Practice

  • Family Medicine Physician
  • Waterville, ME
  • NPI 1386634707
  Medicare reassignment

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1942550058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PROFFESSIONAL PARK RD",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062681659",
            "telephone_number": "860-487-0002",
            "fax_number": "860-429-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PROFFESSIONAL PARK RD",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "062681659",
            "telephone_number": "860-487-0002",
            "fax_number": "860-429-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWICZYK",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "2808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Cooper, LCSW
• Michael Costello, DPT
• Catie Dann
• Kenneth R Dardick, MD
• Noelle Marie Davis, AU.D.
• Mary Day, APRN
• Judith H Dessel, APRN
• Morgan Devane
• Mary Frances Skapek Dieckhaus
• Michael Distefano, MA, ATC, CSCS, PES

• Medical Physician Assistant in Storrs, CT
• Providers in Storrs, CT by specialty
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2012; 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.