Judy Jicinsky, P.T.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

02851 Issued in IA

Practice address

625 32ND Ave SW
Cedar Rapids, IA 52404-3947

Phone

(319) 363-2901

Fax

(319) 363-2903

NPI assigned

Jul 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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 identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Performance Therapies, PC

  • Physical Medicine & Rehabilitation Physician
  • Coralville, IA
  • NPI 1831122837
  Medicare reassignment NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871509224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 EAGLE VIEW CT NW",
            "city": "SWISHER",
            "state": "IA",
            "postal_code": "523389437",
            "telephone_number": "319-981-2276",
            "fax_number": "319-363-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 32ND AVE SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043947",
            "telephone_number": "319-363-2901",
            "fax_number": "319-363-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JICINSKY",
        "first_name": "JUDY",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IA",
            "license": "02851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "30406",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0429027",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "F232553",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00062328",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David E Jensen
• Rachae A Jensen, PA-C
• David Jerkins, M.D.
• Jerry W. Kaalberg, DDS P.C.
• Madilyn Jerry
• Amanda Janae Jilovec, DNP, ARNP
• Jim Cox DDS, PC
• Prachi Jindal, MD
• Robert Alan Jiroutek, RPH
• JN Trusted Care Services, LLC

• Physical Medicine & Rehabilitation Physician in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Physical Medicine & Rehabilitation Physician in Iowa

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.