Mariusz Niedzwiecki

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95017485 Issued in CA

Practice address

2514 Berryessa Rd
San Jose, CA 95132-2947

Phone

(408) 272-1431

NPI assigned

Jun 10, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sharp Rees-Stealy Medical Group IncGroup PAC ID 8628972759, 872 clinicians

Team Physicians of Northern California Medical Group IncGroup PAC ID 7113215146, 84 clinicians

Clinic Services of California Medical Group IncGroup PAC ID 7810209715, 65 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grossmont Hospital Hospital, La Mesa, CA, CCN 050026

Merit-based Incentive Payment System (MIPS)

Final score

88.67 of 100Reported as group

Quality

81.04

Promoting interoperability

99

Improvement activities

40

Cost

82.04

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mniedzwiecki62685@sharphealthcare.direct-ci.com

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.

• Clinic Services of California Medical Group Inc

  • Emergency Medicine Physician
  • Lodi, CA
  • NPI 1578958450

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1285616177

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Team Physicians of Northern California Medical Group Inc

  • Emergency Medicine Physician
  • Pleasanton, CA
  • NPI 1649692716

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Emergency Physicians Associates San Jose PC

  • Emergency Medicine Physician
  • San Jose, CA
  • NPI 1306311576
  Medicare reassignment NPD
• Sharp Rees-Stealy Medical Group, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1063172351
  NPD
• El Camino Health Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Los Gatos, CA
  • NPI 1578831764
  NPD (past)
• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  NPD (past)

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

• Grossmont Hospital Corporation

  • General Acute Care Hospital
  • La Mesa, CA
  • NPI 1528041811
  Care Compare affiliation

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1083281679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 BERRYESSA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322947",
            "telephone_number": "408-272-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 BERRYESSA RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322947",
            "telephone_number": "408-272-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDZWIECKI",
        "first_name": "MARIUSZ",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-10",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017485",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95017485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "50 W Montana Ave",
            "city": "Glendale Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601392646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Bennett Therapy, a Licensed Clinical Social Worker Corp.
• Nicole Hong Phuong T. Thai , M.D., Inc
• Jennifer Lee Nicolet, MSW, MED, LCSW
• Nimisha Nidgundi, D.D.S
• Wenying Nie, L.AC
• Christine S Nieh
• Niel F. Starksen M.D., Inc
• Christine Nielepko, LMFT
• Helle Nielsen-Bowles
• Ea Nielsen, DC

• Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.