Individual provider Active NPI

Jan K Czyzyk, MD

  • Anatomic Pathology Physician
  • Minneapolis, MN
National Provider Identifier
1285617407
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
63410 Issued in MN
Practice address
500 Harvard St SE
Minneapolis, MN 55455-0363
Phone
(612) 273-3000
Fax
(612) 273-4370
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 039224 CT
Anatomic Pathology Physician 207ZP0101X 63410 MN Primary

Addresses

Primary practice location

500 Harvard St SE
Minneapolis, MN 55455-0363

Mailing address

601 Elmwood Avenue
Urmc Box 626
Rochester, NY 14642
Phone (585) 275-3184

Other identifiers 1

IdentifierTypeStateIssuer
001392240MedicaidCT

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180514002492 MN Practitioner - Pathology 3870764004 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

500 Harvard St SE
Minneapolis, MN 55455-0363
Phone (612) 672-7422

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039224CTMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Minnesota Health Clinics and Surgery Center, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Fairview Clinics CurrentSince Jan 9, 2019 Accepting new patients
University of Minnesota Physicians Current Accepting new patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
Fairview Health Services Current Accepting new patients
Fairview Health Services CurrentSince Jan 9, 2019 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
University of Minnesota Physicians CurrentSince Mar 31, 2018 Accepting new patients
Fairview Express Care CurrentSince Mar 6, 2019 Accepting new patients
University of Minnesota Health Clinics and Surgery Center Inc CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 1, 2023 Accepting new patients

Locations

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

420 Delaware St SE
#126
Minneapolis, MN 55455
Phone (612) 626-2378

500 Harvard St SE
Minneapolis, MN 55455
Phone (612) 273-7300

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1285617407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 ELMWOOD AVENUE",
            "address_2": "URMC BOX 626",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14642",
            "telephone_number": "585-275-3184",
            "fax_number": "585-276-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HARVARD ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550363",
            "telephone_number": "612-273-3000",
            "fax_number": "612-273-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZYZYK",
        "first_name": "JAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CT",
            "license": "039224",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MN",
            "license": "63410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001392240",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.