Mr Jack Louis Kaczmarczyk Jr, RN in Plymouth, MI

Mr Jack Louis Kaczmarczyk Jr, RN is a medicare enrolled "Nurse Practitioner - Family" in Plymouth, Michigan. His current practice location is 40600 Ann Arbor Rd E Ste 201, Plymouth, Michigan. You can reach out to his office (for appointments etc.) via phone at (574) 546-1900.

Mr Jack Louis Kaczmarczyk Jr is licensed to practice in Michigan (license number 4704310792) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1427752401.

Contact Information

	Mr Jack Louis Kaczmarczyk Jr, RN
	40600 Ann Arbor Rd E Ste 201, Plymouth, MI 48170-4675
	(574) 546-1900
	(574) 546-1999

Map and Direction

Provider's Profile

Full Name	Mr Jack Louis Kaczmarczyk Jr
Gender	Male
Speciality	Nurse Practitioner - Family
Location	40600 Ann Arbor Rd E Ste 201, Plymouth, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1427752401
Provider Enumeration Date: 03/27/2023
Last Update Date: 10/17/2023

Medicare PECOS Information:

PECOS PAC ID: 1759736960
Enrollment ID: I20231009000437

Medical Identifiers

Medical identifiers for Mr Jack Louis Kaczmarczyk Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1427752401	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	4704310792 (Michigan)	Secondary
363LF0000X	Nurse Practitioner - Family	4704310792 (Michigan)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jack Louis Kaczmarczyk Jr allows following entities to bill medicare on his behalf.

Entity Name	Neurology And Pain Management Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518900620 PECOS PAC ID: 4486676095 Enrollment ID: O20160106002481

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jack Louis Kaczmarczyk Jr is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jack Louis Kaczmarczyk Jr, RN 1748 Chatterson Rd, Muskegon, MI 49442-9467 Ph: (616) 402-7777	Mr Jack Louis Kaczmarczyk Jr, RN 40600 Ann Arbor Rd E Ste 201, Plymouth, MI 48170-4675 Ph: (574) 546-1900

Reviews and Comments

Nurse Practitioner Nurses in Plymouth, MI

Phyllis Smith, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 40600 Ann Arbor Rd E Ste 201, Plymouth, MI 48170 Phone: 574-546-1900 Fax: 574-546-1999
Kimberly Colleen Snowdon, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Thimg Primary Care - Southeast Livonia, 29370 Plymouth Rd Ste 100, Plymouth, MI 48150 Phone: 734-655-8200 Fax: 734-655-8210
Deborah Sue Dunn, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6380 Napier Rd, Plymouth, MI 48170 Phone: 734-451-7553
Marie Sedillo, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 45211 Helm St, Plymouth, MI 48170 Phone: 734-525-9712
Kyle M Farr, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 640 Starkweather St Ste C, Plymouth, MI 48170 Phone: 734-259-2804 Fax: 734-259-2805
Laura Leblanc, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 768 York St, Plymouth, MI 48170 Phone: 810-287-1488 Fax: 734-462-0344
Kathryn Marie Kumor, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9215 Marlowe Ave, Plymouth, MI 48170 Phone: 734-673-1931

Mr Jack Louis Kaczmarczyk Jr, RN - Medicare Nurse Practitioner in Plymouth, MI