Mari E. Janko, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

85002172 Issued in IL

Practice address

16516 Manchester Rd
Wildwood, MO 63040-1217

Phone

(636) 458-8400

Fax

(636) 458-8404

NPI assigned

Aug 25, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mari E Demay Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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 1

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.45 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Saint Louis, MO
  • NPI 1891179040
  Medicare reassignment Care Compare group
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Wentzville, MO
  • NPI 1770396277

  Physician Assistant

  NPD
• St. Louis Dermatology and Surgery Center, PC

  • MOHS-Micrographic Surgery Physician
  • Saint Louis, MO
  • NPI 1659304061
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1063365385
  NPD
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1578515904
  NPD (past)
• Patel Internal Medicine,P.C.

  • Internal Medicine Physician
  • Bethalto, IL
  • NPI 1134320096
  NPD (past)

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1760475628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9016",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16516 MANCHESTER RD",
            "city": "WILDWOOD",
            "state": "MO",
            "postal_code": "630401217",
            "telephone_number": "636-458-8400",
            "fax_number": "636-458-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANKO",
        "first_name": "MARI",
        "middle_name": "E.",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-25",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "85002172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mari.Janko@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "16516 Manchester Rd",
            "city": "Wildwood",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630401217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARI",
            "last_name": "DEMAY",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacques Optometry LLC
• Lisa Jacques
• Peter Damien Jacques, OD
• Julie Ann James, PT, FDNP
• Kiersten Jamison
• Alexandra Johler, DC MS
• Jon Copeland DDS LLC
• Jenna Jordan
• Alana Keller, OD
• Erin C Keller

• Physician Assistant in Wildwood, MO
• Providers in Wildwood, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.