Jennifer S Opdycke, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004149 Issued in MI

Practice address

5708 Venture CT Ste a
Kalamazoo, MI 49009-2858

Phone

(269) 220-0648

Fax

(269) 220-3535

NPI assigned

May 31, 2006

Last updated

Jan 12, 2024By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jennifer.opdycke@295853262569476.direct.elationemr.com
• Direct secure messaging: jopdycke9768@direct.bronsonhg.org

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.

• Swmi Health Matters PLLC

  • Family Medicine Physician
  • Kalamazoo, MI
  • NPI 1619532199
  Authorized official Same address or phone

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1952358160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 VENTURE CT STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092858",
            "telephone_number": "269-220-0648",
            "fax_number": "269-220-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5708 VENTURE CT STE A",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092858",
            "telephone_number": "269-220-0648",
            "fax_number": "269-220-3535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4415 Duke St Ste 2W",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490083224",
            "country_code": "US",
            "telephone_number": "269-459-1272",
            "fax_number": "269-459-1271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPDYCKE",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004149",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BMG",
            "identifier": "1104840529",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952358160",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alexandra Oprescu
• Nicoara Oprescu
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• Physician Assistant in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.