Active NPI
Monika Cieszynski, PA
- Medical Physician Assistant
- Carmichael, CA
National Provider Identifier
1003399981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 56590
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 56590 | CA | MD | Medical Physician Assistant |
| 085.006694 | IL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hussam Kujok MD Inc | Current | 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.
-
- Internal Medicine Physician
- Carmichael, CA
- NPI 1225321292
-
- Plastic Surgery Physician
- Chicago, IL
- NPI 1306079298
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.