Individual provider Active NPI

Carolyn Cristi Janik, PA-C

  • Surgical Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1144534595
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4643 Issued in AZ
Practice address
18444 N 25TH Ave Ste 210
Phoenix, AZ 85023-1264
Phone
(623) 537-5600
Fax
(866) 939-2673
NPI assigned
Jul 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 4643 AZ Primary

Addresses

Primary practice location

18444 N 25TH Ave Ste 210
Phoenix, AZ 85023-1264

Mailing address

18444 N 25TH Ave
Suite 310
Phoenix, AZ 85023-1261
Phone (623) 537-5600

Other identifiers 1

IdentifierTypeStateIssuer
679571MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20110816000561 AZ Practitioner - Physician Assistant 9436327889 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Educatoin CurrentSince Jun 29, 2014 Accepting new patients
Center for Orthopedic Research and Education, LLC Physician Assistant Past Accepting new patients

Locations

3420 S Mercy Rd
Ste 200
Gilbert, AZ 85297
Phone (480) 909-3788

1500 S Dobson Rd
Ste 202
Mesa, AZ 85202
Phone (866) 974-2676

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

18444 N 25th Ave
Ste 220
Phoenix, AZ 85023
Phone (669) 742-6738

9321 W Thomas Rd
Ste 205
Phoenix, AZ 85037

18444 N 25th Ave
Ste 210
Phoenix, AZ 85023
Phone (669) 742-6738

8952 E Desert Cove Ave
Ste 113
Scottsdale, AZ 85260
Phone (480) 314-7772

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

13995 W Statler Blvd
Ste 165
Surprise, AZ 85374
Phone (623) 537-5661

Interoperability endpoints

  • Direct secure messaging: carolyn.janik.1@22724.direct.athenahealth.com

Organizations & group practices 4

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": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1144534595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "SUITE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231264",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANIK",
        "first_name": "CAROLYN",
        "middle_name": "CRISTI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": "4643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679571",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.