Individual provider Active NPI

Randy J Janczyk, MD

  • Surgery Physician
  • Royal Oak, MI
National Provider Identifier
1811988058
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301067765 Issued in MI
Practice address
3535 W 13 Mile Rd
Ste 204
Royal Oak, MI 48073
Phone
(248) 551-9090
Fax
(248) 551-9080
NPI assigned
Nov 4, 2005
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4301067765 MI Primary

Addresses

Primary practice location

3535 W 13 Mile Rd
Ste 204
Royal Oak, MI 48073

Mailing address

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334-3292
Phone (248) 851-1430

Other practice location 1

3535 W 13 Mile Rd Ste Ll
Royal Oak, MI 48073-6770
Phone (248) 551-3000

Other practice location 2

44199 Dequindre Rd Ste 315
Troy, MI 48085-1128
Phone (248) 964-3600

Other practice location 3

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-2800

Other identifiers 1

IdentifierTypeStateIssuer
0206311192OtherBC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address janczyk9294@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20100615000918 MI Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 7911037130 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
University of Texas Medical School at San Antonio, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians

Practice addresses (Care Compare)

27900 Grand River Ave
Suite 220
Farmington Hills, MI 48336-5965
Phone (248) 477-0552

3535 W 13 Mile Rd
Royal Oak, MI 48073-6770

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712

3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-0575

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)36
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301067765MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC CurrentSince Jun 1, 2017 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince May 17, 2023 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Jun 1, 2017 Accepting new patients
William Beaumont Hospital Past Accepting new patients
Port Huron Mercy Family Care Inc Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

3535 W 13 Mile Rd
Royal Oak, MI 48073
Phone (248) 551-1010

3535 W 13 Mile Rd
Ste 204
Royal Oak, MI 48073
Phone (248) 551-9090

3535 W 13 Mile Rd
Ste Ll
Royal Oak, MI 48073
Phone (248) 551-3000

3601 W 13 Mile Rd
Royal Oak, MI 48073

44199 Dequindre Rd
Ste 315
Troy, MI 48085
Phone (248) 964-1170

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: janczyk9294@direct.beaumont.edu
  • Direct secure messaging: rjanczyk1456739@epic00.shdirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1811988058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY",
            "address_2": "STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD",
            "address_2": "STE 204",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "48073",
            "telephone_number": "248-551-9090",
            "fax_number": "248-551-9080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste Ll",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-3000",
            "fax_number": "248-551-4784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "44199 Dequindre Rd Ste 315",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480851128",
            "country_code": "US",
            "telephone_number": "248-964-3600",
            "fax_number": "248-964-1188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-2800",
            "fax_number": "248-898-2898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JANCZYK",
        "first_name": "RANDY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301067765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "0206311192",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janczyk9294@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.