Jan Radzik, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD 17050 Issued in OR

Practice address

349 SE Baker St
McMinnville, OR 97128-6039

Phone

(503) 472-9438

Fax

(503) 472-9439

NPI assigned

Jan 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Home Health Home health agency, Portland, OR, CCN 387048
• Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Jan Radzik, MD PC

  • Primary Care Clinic/Center
  • McMinnville, OR
  • NPI 1295037968
  Medicare reassignment NPD Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services Oregon

  dba Providence Home Health

  • Home Health Agency
  • Portland, OR
  • NPI 1790873461
  Care Compare affiliation
• Willamette Valley Medical Center LLC

  dba Willamette Valley Medical Center

  • General Acute Care Hospital
  • McMinnville, OR
  • NPI 1346269982
  Care Compare affiliation

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

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1053467357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-472-9438",
            "fax_number": "503-472-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-472-9438",
            "fax_number": "503-472-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZIK",
        "first_name": "JAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD 17050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029186",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faith Margaret Purvis, DNP, PMHNP, FNP
• Tami Putzier
• Oley Quast, MA, LPC, CADC II
• Gail Quenneville, LCSW
• Radiation Therapy Consultants, PC
• Rainbow Family Services
• Derek D. Rains, M.D.
• Virginia Marie Rake
• Katimarie Ralston, DDS
• Shelby Ramer

• Family Medicine Physician in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.