Jan Radzik, MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD17050 Issued in OR

Legal business name

JAN RADZIK, MD PC

Practice address

349 SE Baker St
McMinnville, OR 97128-6039

Phone

(503) 472-9438

Fax

(503) 472-9439

NPI assigned

Dec 1, 2010

Organization subpart

No

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

Authorized official

Name

Jan None Radzik, MDNPI 1053467357

Title

President

Phone

(503) 472-9438

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jan Radzik, MD Other name

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jan Radzik, M.D.

  • Family Medicine Physician
  • McMinnville, OR
  • NPI 1053467357
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1295037968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-472-9438",
            "fax_number": "503-472-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 SE BAKER ST",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286039",
            "telephone_number": "503-472-9438",
            "fax_number": "503-472-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN RADZIK, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "RADZIK",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "NONE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-472-9438",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OR",
            "license": "MD17050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029186",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jan Radzik, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Jake
• Julia Jakubowski
• James B Nelson, PC
• Jim A James, M.D.
• Taryn James
• Deborah Janke
• McKenna Rose Jaques
• Hannah Elizabeth Jarvis
• JHS Inc
• Kyle Gregory Johansen

• Primary Care Clinic/Center in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Primary Care Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.