STANISLAW P DAJCZAK (NPI# 1104819705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104819705 |
| Entity Type | Individual |
| Full Name | STANISLAW P DAJCZAK |
| Credential | MD |
| Practice Address |
1250 Ralston Ave Suite 102 Defiance OH 43512-5311 |
| Practice Telephone | 4197836996 |
| Practice Fax Number | 4197828062 |
| Mailing Telephone | 4197836996 |
| Mailing Fax Number | 4197828062 |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2012-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 35085114 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | UHC | 17-98831 | 01 |
| OH | PHC | 04648 | 01 |
| OH | RRMC | PO0192953 | 01 |
| OH | ANTHEM | 000000362612 | 01 |
| OH | 2542001 | 05 | |
| AETNA | 5598615 | 01 | |
| OH | RRMC | P00192953 | 01 |
| Street Address |
1250 RALSTON AVE SUITE 102 |
| City | DEFIANCE |
| State | OH |
| Zip Code | 43512-5311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661805 | James T Harger | Physician Assistant | 1250 Ralston Ave, Ste 102, Defiance, OH 43512-5311 | 2005-07-01 |
| 1851842363 | Melchor L. Mercado M.d. A Professional Corporation | Psychologist | 1250 Ralston Ave, Defiance, OH 43512-5311 | 2016-10-19 |
| 1669868535 | Kaylin Schwartz | Physician Assistant | 1250 Ralston Ave, Suite 102, Defiance, OH 43512-5311 | 2015-04-08 |
| 1427495092 | Joshua Michael Lucas | Family Medicine | 1250 Ralston Ave, Suite 204, Defiance, OH 43512-5311 | 2013-05-22 |
| 1821369307 | Midwest Cardiovascular Consultants LLC | Internal Medicine | 1250 Ralston Ave, Suite 203a, Defiance, OH 43512-5311 | 2012-01-16 |
| 1952680514 | Promedica Central Physicians | Internal Medicine | 1250 Ralston Ave, Suite 106, Defiance, OH 43512-5311 | 2011-08-12 |
| 1225345549 | Bethany Anne Graham | Nurse Practitioner | 1250 Ralston Ave, Suite 204, Defiance, OH 43512-5311 | 2010-09-08 |
| 1104953959 | Promedica West Physicians, LLC | Obstetrics & Gynecology | 1250 Ralston Ave, Suite 205, Defiance, OH 43512-5311 | 2007-02-28 |
| 1831226687 | Promedica West Physicians, LLC | Family Medicine | 1250 Ralston Ave, Suite 106, Defiance, OH 43512-5311 | 2007-02-28 |
| 1801923503 | Promedica West Physicians, LLC | Surgery | 1250 Ralston Ave, Suite 203, Defiance, OH 43512-5311 | 2007-02-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174098768 | Dr. Bradley Pittman Dds Ltd. | Oral & Maxillofacial Surgery | 205 E. Second St., Defiance, OH 43512 | 2018-10-10 |
| 1285115147 | Tamara Lynn Junge | Social Worker | 1252 Ralston Avenue, #401, Defiance, OH 43512 | 2018-08-28 |
| 1306207568 | Deborah Lehnert | Licensed Practical Nurse | 511 Perry Street, Defiance, OH 43512 | 2016-03-16 |
| 1265857924 | P & R Home Iv Service, Inc. | Durable Medical Equipment & Medical Supplies | 1018 Ralston Avenue, Suite 107, Defiance, OH 43512 | 2014-03-04 |
| 1609020155 | Christina Marie Pergram | Physician Assistant | 1250 Rlaston Ave, Suite 104, Defiance, OH 43512 | 2008-11-11 |
| 1477740785 | Assisted Living Concepts Inc | Assisted Living Facility | 245 North Rosewood Avenue, Defiance, OH 43512 | 2007-10-01 |
| 1720127863 | Kathy Williams Homier | Counselor | 815 E Second St, Defiance, OH 43512 | 2007-02-05 |
| 1407944960 | Oak Health Care Investors of Defiance, Inc. | Durable Medical Equipment & Medical Supplies | 1701 South Jefferson Ave, Defiance, OH 43512 | 2006-10-10 |
| 1184733719 | Shane Aaron Klingler | Chiropractor | 1770 Jefferson Ave, Defiance, OH 43512 | 2006-08-29 |
| 1396751327 | Elizabeth Marie Seibert | Pharmacist | 1245 E Second St, Defiance, OH 43512 | 2006-07-31 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578961157 | Orthopaedic Institute of Ohio, Inc. | Orthopaedic Surgery | 1404 E 2nd St, Defiance, OH 43512-2440 | 2014-12-12 |
| 1548397938 | Promedica Central Physicians, LLC | Orthopaedic Surgery | 1250 Ralston Ave, Suite 102, Defiance, OH 43512-5311 | 2007-02-27 |
| 1649252701 | Nathan A. Fogt | Orthopaedic Surgery | 1400 E 2nd St, Defiance, OH 43512-2440 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966327 | Crystal Clinic, Inc. | Orthopaedic Surgery | 2383 S Main St Ste D106, Coventry Township, OH 44319-1190 | 2020-09-09 |
| 1306468418 | Mercy Health Physicians North Specialty Care LLC | Orthopaedic Surgery | 2200 Jefferson Ave Fl 4, Toledo, OH 43604-7102 | 2020-05-12 |
| 1841756632 | Ortholive Medical Group | Orthopaedic Surgery | 1311 Vine St, Cincinnati, OH 45202-7118 | 2019-02-16 |
| 1487134581 | Orthopedic One, Inc. | Orthopaedic Surgery | 5500 N. Meadows Drive, Grove City, OH 43123 | 2018-08-17 |
| 1659851921 | Orthopaedic Associates, Inc | Orthopaedic Surgery | 32800 Lorain Rd # 1100, N Ridgeville, OH 44039-3430 | 2018-08-16 |
| 1841788593 | Yirka Vacca | Orthopaedic Surgery | Cleveland Clinic 9500 Euclid Avenue A-40, Cleveland, OH 44195 | 2018-04-27 |
| 1609387984 | Orthopedic Associates of S W Ohio Inc | Orthopaedic Surgery | 3535 Pentagon Blvd Ste 300, Beavercreek, OH 45431-1705 | 2017-10-13 |
| 1689183683 | Orthopedic Associates of S W Ohio, Inc. | Orthopaedic Surgery | 7117 Dutchland Pkwy, Liberty Township, OH 45044-9096 | 2017-09-22 |
| 1760914451 | Morad Chughtai | Orthopaedic Surgery | 10001 Chester Ave, Apt 520, Cleveland, OH 44106-1617 | 2017-03-31 |
| 1306382262 | Zanesville Xpress Ortho Care, LLC | Orthopaedic Surgery | 3089 Maple Ave, Zanesville, OH 43701-1408 | 2017-01-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.