Michael John Jarzombek, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1282 Issued in NH

Practice address

30 Canton St
Suite 13
Manchester, NH 03103-3524

Phone

(603) 625-1670

Fax

(603) 625-0335

NPI assigned

Oct 6, 2006

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

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of New HampshireGroup PAC ID 3870530579, 77 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• The New London Hospital Association, Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • New London, NH
  • NPI 1518007236

  Corporate Officer

  CMS ownership

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.

• State of New Hampshire

  dba New Hampshire Hospital

  • Psychiatric Hospital
  • Concord, NH
  • NPI 1861491334
  Medicare reassignment Care Compare group NPD
• State of New Hampshire

  dba Hampstead Hospital

  • Psychiatric Hospital
  • Hampstead, NH
  • NPI 1952450082
  NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1285721951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 QUAKER ST",
            "city": "WEARE",
            "state": "NH",
            "postal_code": "032814514",
            "telephone_number": "603-529-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CANTON ST",
            "address_2": "SUITE 13",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031033524",
            "telephone_number": "603-625-1670",
            "fax_number": "603-625-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARZOMBEK",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "601",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NH",
            "license": "1282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer A. Januario, M.D.
• Jessica Janus, LCMHC
• Erica Jaquish, MSW
• Alexandria Jarvis, APRN
• Stuart Craig Jarvis, MD
• Taunya Jarzyniecki, LCMHC, MLADC
• Jason E. Sudati, DMD, PC (Amoskeag Family Dentistry)
• Leanna Jason, PT, DPT
• Sally Ann Jasper, LICSW
• Sara Jastrzebski, MA, LCMHC, CCTP, NCC

• Psychologist in Manchester, NH
• Providers in Manchester, NH by specialty
• Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.