George J. Jacewicz, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4047 Issued in RI

Practice address

95 Toll Gate Rd
Warwick, RI 02886-4443

Phone

(401) 738-6111

Fax

(401) 732-0155

NPI assigned

Aug 23, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in RI

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

Otolaryngology

Education

Other, 1962

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• George J Jacewicz, M. D., Inc

  • Otolaryngology Physician
  • Warwick, RI
  • NPI 1447502729
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639162951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864443",
            "telephone_number": "401-738-6111",
            "fax_number": "401-732-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864443",
            "telephone_number": "401-738-6111",
            "fax_number": "401-732-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACEWICZ",
        "first_name": "GEORGE",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "RI",
            "license": "4047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GJ00045",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nicholas Jackson, LMHC
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• Jaclyn Houston Therapy LLC
• Beck Jacobsen, MD

• Otolaryngology Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Otolaryngology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.