Organization Active NPI

Izbicki Family Medicine PC

  • Family Medicine Physician
  • Erie, PA
National Provider Identifier
1346579331
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
IZBICKI FAMILY MEDICINE PC
Practice address
3424 Peach St
Erie, PA 16508-2740
Phone
(814) 864-3749
Fax
(814) 864-9757
NPI assigned
Dec 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Jonathon A Izbicki, DONPI 1134128523
Title
Pres
Phone
(814) 504-6506

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3424 Peach St
Erie, PA 16508-2740

Mailing address

717 State St
Suite 16, LL
Erie, PA 16501-1341
Phone (814) 877-7100

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2004591Izbicki Family Medicine PC3424 Peach Street, Erie, PA 16508Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1346579331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 STATE ST",
            "address_2": "SUITE 16, LL",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011341",
            "telephone_number": "814-877-7100",
            "fax_number": "814-877-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3424 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165082740",
            "telephone_number": "814-864-3749",
            "fax_number": "814-864-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IZBICKI FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-22",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "IZBICKI",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "814-504-6506",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.