Lawrence Jedlicka, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

43103 Issued in KY

Practice address

4001 Laurel St
Anchorage, AK 99508-5300

Phone

(907) 677-1012

Fax

(907) 565-6001

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KY, AK2 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

Neurology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kentuckyone Health Medical Group IncGroup PAC ID 8820993702, 260 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Joseph Hospital Hospital, Lexington, KY, CCN 180010

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kentuckyone Health Medical Group, Inc.

  • Family Medicine Physician
  • Lexington, KY
  • NPI 1104875970
  Medicare reassignment Care Compare group NPD
• Alaska Neurology Center LLC

  • Neurology Physician
  • Anchorage, AK
  • NPI 1235310954
  Medicare reassignment NPD

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

• Saint Joseph Health System Inc

  • Clinical Medical Laboratory
  • Lexington, KY
  • NPI 1215227012

  Hospital

  Care Compare affiliation
• Saint Joseph Health System, Inc

  • General Acute Care Hospital
  • Lexington, KY
  • NPI 1437150984
  Care Compare affiliation
• Saint Joseph Health System, Inc

  • Clinic/Center
  • Nicholasville, KY
  • NPI 1861650814

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1508958521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LAUREL ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085300",
            "telephone_number": "907-677-1012",
            "fax_number": "907-565-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LAUREL ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085300",
            "telephone_number": "907-677-1012",
            "fax_number": "907-565-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEDLICKA",
        "first_name": "LAWRENCE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "GA",
            "license": "069361",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "22378",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "43103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JC Faith Open Arms 1
• JC Faith Open Arms 3
• Devin A Jean-Marie
• Brenda Mae Jedlicka, LMT
• Kimberly Jedlicka, M.D.
• Donna Jefferson, BS
• Tina Jefferson
• Kimberly Jeffery
• Jeffrey C Trotter
• Jeffrey D Medland, LLC

• Neurology Physician in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Neurology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.