Joanne Marie Churak, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000161 Issued in CT

Practice address

950 Campbell Ave
Renal Section, 111F
West Haven, CT 06516

Phone

(203) 932-5711

Fax

(203) 937-3455

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421107200000",
    "number": "1255423232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "RENAL SECTION, 111F",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-932-5711",
            "fax_number": "203-937-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "address_2": "RENAL SECTION, 111F",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-932-5711",
            "fax_number": "203-937-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURAK",
        "first_name": "JOANNE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Chodkowski, R.N.
• Jimmy Choi, PSY.D.
• Yunmi Choi
• Andrew Chou, M.D.
• Eun Gul Chung, FNP-BC
• Robert Ciarlo
• Christopher Michael Cicero, PHARMD
• Jezerca Cina
• Cindy Avila, LPC
• City of West Haven

• All providers in West Haven, CT
• Medical Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.