Individual provider Active NPI

Monika Cieszynski, PA

  • Medical Physician Assistant
  • Carmichael, CA
National Provider Identifier
1003399981
Registry record updated Dec 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
56590 Issued in CA
Practice address
3609 Mission Ave Ste a
Carmichael, CA 95608-2955
Phone
(916) 971-9000
Fax
(916) 971-9010
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.006694 IL
Medical Physician Assistant 363AM0700X 56590 CA Primary

Addresses

Primary practice location

3609 Mission Ave Ste a
Carmichael, CA 95608-2955

Mailing address

1717 Roslyn Rd
Roselle, IL 60172-4904

Other practice location 1

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 362-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
56590CAMDMedical Physician Assistant
085.006694ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hussam Kujok MD Inc CurrentSince Dec 29, 2019 Accepting new patients
Northwestern Specialists in Plastic Surgery, S.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576886400000",
    "number": "1003399981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 ROSLYN RD",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601724904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 MISSION AVE STE A",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956082955",
            "telephone_number": "916-971-9000",
            "fax_number": "916-971-9010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 S Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600483204",
            "country_code": "US",
            "telephone_number": "847-362-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIESZYNSKI",
        "first_name": "MONIKA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2019-12-21",
        "certification_date": "2019-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.006694",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "56590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmichael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.