Jonathan J Cichocki, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

G0609 Issued in TX

Practice address

818 W Terrell Ave
Fort Worth, TX 76104-3133

Phone

(817) 335-1875

NPI assigned

Nov 30, 2005

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 2

Medicare fee-for-service enrollment

Enrolled in TX

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

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1861476376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W TERRELL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W TERRELL AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043133",
            "telephone_number": "817-335-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICHOCKI",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G0609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0352239-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "826183519",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sun A Chung, FNP
• Ashley Marie Church, FNP
• William Allen Church, PHYSICAL THERAPIST
• Nick J Cianelli, D.C.
• Kelsea F Ciavaglia, A-SLP
• Luke Alexander Cielonko, D.O.
• Mehmet Cilingiroglu, M.D.
• Michael Lewis Cimo, MD
• Joseph Michael Cinelli, D.M.D.
• Emily Ruth Cinque, LPC, M.ED

• Specialist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.