Individual provider Active NPI

Roxanne Janisko, CRNP

  • Family Nurse Practitioner
  • Johnstown, PA
National Provider Identifier
1235146143
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
VP 006951B Issued in PA
Practice address
1425 Scalp Ave
Johnstown, PA 15904-3328
Phone
(814) 266-8696
Fax
(814) 266-9382
NPI assigned
Aug 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X VP 006951B PA Primary

Addresses

Primary practice location

1425 Scalp Ave
Johnstown, PA 15904-3328

Mailing address

1425 Scalp Ave
1425 Scalp Avenue
Johnstown, PA 15904-3328
Phone (814) 266-8696

Other identifiers 2

IdentifierTypeStateIssuer
VPOO6951BOtherPANURSE PRACTITIONER
RN208491LOtherPAREGISTERED NURSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130529000783 PA Order and Referring Only - Nurse Practitioner 3476741067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
VP 006951BPAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235146143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 SCALP AVE",
            "address_2": "1425 SCALP AVENUE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043328",
            "telephone_number": "814-266-8696",
            "fax_number": "814-266-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 SCALP AVE",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043328",
            "telephone_number": "814-266-8696",
            "fax_number": "814-266-9382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANISKO",
        "first_name": "ROXANNE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "VP 006951B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "VPOO6951B",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "RN208491L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.