NPIMap

Individual provider Active NPI

Adam Janicki, M.D.

  • Emergency Medicine Physician
  • Providence, RI
National Provider Identifier
1457611402
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD19691 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4247
Fax
(401) 444-6662
NPI assigned
May 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD19691 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160405002400 PA Practitioner - Emergency Medicine 3870710270 Reassigns benefits to 1 organization
I20240315003407 RI Practitioner - Emergency Medicine 3870710270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Emergency MedicineGroup PAC ID 7214833169, 140 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-7024

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.45 of 100Reported as group
Quality
85.46
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.94 of 100Reported as group
Quality
61.89
Promoting interoperability
100
Improvement activities
40
Cost
74.58

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19691RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group Inc CurrentSince Feb 1, 2026 Accepting new patients
Lifespan Corporation Current Accepting new patients
University of Pittsburgh Physicians CurrentSince Apr 1, 2016 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Lifespan Physician Group, Inc. Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
Brown Emergency Medicine Emergency Medicine CurrentSince May 1, 2024 Accepting new patients
University of Pittsburgh Physicians Emergency Medicine CurrentSince Apr 1, 2016 Accepting new patients

Locations

200 Lothrop St
Pittsburgh, PA 15213
Phone (412) 647-3553

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

125 Whipple St
Ste 3
Providence, RI 02908
Phone (401) 854-2504

Interoperability endpoints

  • Direct secure messaging: ajanicki7582@brownhealth.medalliesdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 6

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1457611402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4247",
            "fax_number": "401-444-6662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4247",
            "fax_number": "401-444-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANICKI",
        "first_name": "ADAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD19691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.