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MICHAEL DEDVUKAJ MD
NPI 1629810684
Student in an Organized Health Care Education/Training Program in Port Huron, MI

Active since June 11, 2024PECOS Enrolled
1216 RICHARDSON ST, PORT HURON, MI 48060(810) 985-2640(810) 962-8294 Get Directions Write a Review

NPPES record last updated: June 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 17, 2024, Jun 11, 2024 (2 updates tracked since 2024).

About Michael Dedvukaj Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL DEDVUKAJ MD (NPI 1629810684) is an individual student in an organized health care education/training program in Port Huron, Michigan, licensed in Michigan (5315249016) and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1629810684
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMICHAEL DEDVUKAJCredential: MD
Location Address1216 RICHARDSON STPort Huron, MI 48060-3549
Mailing Address1216 Richardson StPort Huron, MI 48060-3549 · (810) 985-2640 · Fax (810) 962-8294
Phone(810) 985-2640
Fax(810) 962-8294
Sole ProprietorNo
Enumeration DateJune 11, 2024
Last NPPES UpdateJune 17, 20242 updates tracked since enumeration
NPPES CertifiedJune 17, 2024
✔ NPI 1629810684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in MI · 5315249016
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1216 RICHARDSON ST, Port Huron, MI 48060
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Dedvukaj Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARA E LITER-KUESTER DO
Internal Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
MAXWELL BROWN
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
MEHMET ISMAILOGLU MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
ADITI KUKREJA DO
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
JESSICA ANN JORGE MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640
ASSOCIATES FOR INTERNAL MEDICINE, P.C.
Internal Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-6777
RICHARD J HEGLUND MD
Family Medicine
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2620
NEHA UPPAL MD
Student in an Organized Health Care Education/Training Program
1216 RICHARDSON ST
PORT HURON, MI 48060
St. Clair County (810) 985-2640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Dedvukaj's NPI number?

The NPI number for Michael Dedvukaj is 1629810684. It was assigned to this individual provider in the NPPES registry on June 11, 2024.

Where is Michael Dedvukaj located?

Michael Dedvukaj practices at 1216 Richardson St, Port Huron, MI 48060. The listed phone number is (810) 985-2640.

What is Michael Dedvukaj's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Michael Dedvukaj enrolled in Medicare?

Yes. Michael Dedvukaj is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Michael Dedvukaj was last updated on June 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.