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DR. JACK S. BARTOSZEK D.O. NPI 1093714818


NPI Information

NPI: 1093714818
Provider Name: DR. JACK S. BARTOSZEK, D.O.
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

PECOS Registration: Yes

Address:
615 FULMER RD
MISHAWAKA, IN
ZIP 46544
Phone: (574) 252-3085
Get Directions

DR. Jack S. Bartoszek, D.O. is a geriatric medicine family medicine in Mishawaka, IN. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. DR. Jack S. Bartoszek, D.O. NPI is 1093714818. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

615 FULMER RD
MISHAWAKA, IN
ZIP 46544-911
Phone: (574) 252-3085
Fax: (574) 252-5906

The NPI 1093714818 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2005 and was last updated on 9/20/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QG0300XFamily MedicineGeriatric Medicine02001105INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1184640EMEDICARE PININDIANA
2080093853 RR MED.MEDICARE PININDIANA
3E33584MEDICARE UPIN
4100335800AMEDICAIDINDIANA
5000000109340OTHERINDIANAANTHEM NUMBER
6OA41009OTHERMICHIGANBCBSM
7N99060005MEDICARE PINMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.