Michelle Mary Jancaric, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

76498 Issued in MN

Practice address

2945 Hazelwood St Ste 100
Maplewood, MN 55109-1242

Phone

(651) 232-7800

Fax

(651) 232-7940

NPI assigned

May 19, 2021

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

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjancaric454429@fairview.direct-ci.com

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.

• Healtheast Medical Research Institute

  • Clinic/Center
  • Vadnais Heights, MN
  • NPI 1639125503
  Medicare reassignment NPD
• Healtheast Medical Research Institute

  • Internal Medicine Physician
  • Saint Paul, MN
  • NPI 1508191552
  NPD
• Healtheast Medical Research Institute

  • Family Medicine Physician
  • Maplewood, MN
  • NPI 1710147954
  NPD
• Healtheast Medical Research Institute

  • Clinic/Center
  • Oakdale, MN
  • NPI 1073569935
  NPD (past)
• Healtheast St. John'S Hospital

  • General Acute Care Hospital
  • Maplewood, MN
  • NPI 1447218482
  NPD (past)
• Healtheast Woodwinds Hospital

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1356309322
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1790359164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 100",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091242",
            "telephone_number": "651-232-7800",
            "fax_number": "651-232-7940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2450 Riverside Avenue",
            "address_2": "Pediatrics Ed Office M136, 1st Floor, East Building",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "55454",
            "country_code": "US",
            "telephone_number": "612-624-4477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANCARIC",
        "first_name": "MICHELLE",
        "middle_name": "MARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "76498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Suzanne Jagusch, LICSW
• Louie Anthony Garcia Jain, MD
• Catherine Ann Jaksha, LADC, LPCC
• Donna M Jalonen, MSW LICSW
• James Pitzner Enterprises LLC
• Julie Overboe Jarvis, DO
• Jensen & Jensen DDS PA
• Taleasha Jerde
• Fatuma Osman Jibrell
• Johnson Spine and Joint PLLC

• Pediatrics Physician in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.