Mary Beth Janicki, M.D.

Primary specialty

Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X

License

041341 Issued in CT

Practice address

114 Woodland St
Hartford, CT 06105-1208

Phone

(860) 714-4595

Fax

(860) 714-8008

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT, MA2 enrollments

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 2

Specialty

Obstetrics/Gynecology

Education

Columbia University College of Physicians and Surgeons, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Trinity Health of New England Provider Network Organization IncGroup PAC ID 0941113567, 644 clinicians

Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjanicki2387888@direct.trinity-health.org

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.

• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Riverbend Medical Group, Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Mercy Medical Group, Inc.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1316213143
  NPD (past)

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

• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1407947526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ASYLUM AVE",
            "address_2": "2109A",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051770",
            "telephone_number": "860-714-6581",
            "fax_number": "860-714-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 WOODLAND ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051208",
            "telephone_number": "860-714-4595",
            "fax_number": "860-714-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANICKI",
        "first_name": "MARY BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CT",
            "license": "041341",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CT",
            "license": "041341",
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CT",
            "license": "041341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "041341",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjanicki9555@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Trinity Health of New England Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ccd",
            "address_1": "114 Woodland St",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061051208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana James, M.D., PH.D.
• Jaime Marie James, DPM
• Krystal James
• Lillian Nora James
• Patricia D Jaminet, RDH BS
• Rachel Jankovsky, PA
• Kozeta Jano
• Nancy Brown Janus, LCSW
• Gitti Janwatanagool, M.D.
• Rolf P Janzen, MD

• Maternal & Fetal Medicine Physician in Hartford, CT
• Providers in Hartford, CT by specialty
• Maternal & Fetal Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.
• 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.