Matthew Janowicz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3046 Issued in SC

Practice address

5046 Highway 17 Byp S Ste 103
Myrtle Beach, SC 29588-4503

Phone

(843) 668-4104

Fax

(843) 668-4108

NPI assigned

Nov 24, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Dermatology Institute LLCGroup PAC ID 4981005063, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Coastal Dermatology Institute LLC

  • MOHS-Micrographic Surgery Physician
  • Myrtle Beach, SC
  • NPI 1174122444
  Medicare reassignment Care Compare group
• Rhode Island Dermatology & Cosmetic Center LLC

  • Specialist
  • Lincoln, RI
  • NPI 1972676021
  Medicare reassignment

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1558735878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 GREEN POND RD STE C",
            "city": "ROCKAWAY",
            "state": "NJ",
            "postal_code": "078662057",
            "telephone_number": "973-625-0600",
            "fax_number": "973-625-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5046 HIGHWAY 17 BYP S STE 103",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295884503",
            "telephone_number": "843-668-4104",
            "fax_number": "843-668-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANOWICZ",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5586",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "3046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeannie James, LPC, LAC
• Joby K Janardhanan, AGACNP-BC
• Gabrielle Margareth Janes, FNP-C
• Anna Janke
• Mark J Janosky, D.M.D.
• Connor Michael Jansen, PA-C
• Robert Jansen
• Jennifer Lynn Janson
• Omar Jaraki, MD
• Christina L Jardak, MD/MPH

• Physician Assistant in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Physician Assistant in South Carolina

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