Marcus Matthew Janicki, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS12477 Issued in FL

Practice address

3030 North Rocky Point Drive West
Suite 670
Tampa, FL 33607-5906

Phone

(813) 289-6597

Fax

(813) 289-6592

NPI assigned

Jul 25, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Specialty

Family Practice

Education

West Virginia School of Osteopathic Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunstate Physicians LLCGroup PAC ID 3577813617, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Keystone Home Health Inc Home health agency, St Petersburg, FL, CCN 108469
• Suncoast Hospice Hospice, Palm Harbor, FL, CCN 101508
• Sabal Palms Health & Rehabilitation Nursing home, Largo, FL, CCN 105694
• Oak Manor Healthcare & Rehabilitation Center Nursing home, Largo, FL, CCN 105248
• Freedom Square Health Care Center Nursing home, Seminole, FL, CCN 106042
• Aviata at Countryside Nursing home, Palm Harbor, FL, CCN 105587
• Wrights Healthcare and Rehabilitation Center Nursing home, Seminole, FL, CCN 105849

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• CCRC Opco-Freedom Square, LLC

  • Skilled Nursing Facility
  • Seminole, FL
  • NPI 1780098202

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Sunstate Physicians LLC

  • Hospitalist Physician
  • Boca Raton, FL
  • NPI 1750872545
  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597

  Hospitalist

  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• Inpatient Consultants of Florida, Inc.

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1285037622

  Family Medicine

  NPD (past)
• QMC LLC

  • Hospitalist Physician
  • Miami, FL
  • NPI 1003216391
  NPD (past)
• Inpatient Consultants of Alabama, Inc

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1235238916

  Hospitalist

  NPD (past)

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

• CCRC Opco-Freedom Square, LLC

  • Skilled Nursing Facility
  • Seminole, FL
  • NPI 1780098202

  Nursing home

  Care Compare affiliation
• Countryside Blvd Opco LLC

  • Skilled Nursing Facility
  • Palm Harbor, FL
  • NPI 1568141638

  Nursing home

  Care Compare affiliation
• J1513, LLC

  • Skilled Nursing Facility
  • Largo, FL
  • NPI 1548985260

  Nursing home

  Care Compare affiliation
• J2112, LLC

  • Skilled Nursing Facility
  • Seminole, FL
  • NPI 1538884259

  Nursing home

  Care Compare affiliation
• Keystone Home Health, Inc.

  • Home Health Agency
  • Saint Petersburg, FL
  • NPI 1609976950
  Care Compare affiliation
• Medinvest Company Limited Partnership

  • Skilled Nursing Facility
  • Largo, FL
  • NPI 1063440493

  Nursing home

  Care Compare affiliation
• The Hospice of the Florida Suncoast, Inc.

  • Community Based Hospice Care Agency
  • Palm Harbor, FL
  • NPI 1124028204
  Care Compare affiliation

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

{
    "created_epoch": "1280016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427760000000",
    "number": "1609189240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 NORTH ROCKY POINT DRIVE WEST",
            "address_2": "SUITE 670",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "813-289-6597",
            "fax_number": "813-289-6592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 NORTH ROCKY POINT DRIVE WEST",
            "address_2": "SUITE 670",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075906",
            "telephone_number": "813-289-6597",
            "fax_number": "813-289-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANICKI",
        "first_name": "MARCUS",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-25",
        "last_updated": "2015-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.1240",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS12477",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AL",
            "license": "DO.1240",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "OS12477",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134283",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Hidalgo, OD, PLLC
• Janet Marley M.D.,P.a.
• Jasmine Meesoon Jang
• Hemangini Ashokkumar Jani, OT
• Katie Janicki
• Michelle Janicki, PA-C
• Sindhura Janjanam
• Zarah Janneh, PA-C
• Chiranjivi Bharath Jannu, R.PH., C,PH
• Smruthi Jannu, PHARMD

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.