Andrea Michelle Gorjaczew, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

OS11252 Issued in FL

Practice address

820 Prudential Dr
Suite 713
Jacksonville, FL 32207-8210

Phone

(800) 936-5996

Fax

(904) 346-0864

NPI assigned

Jul 2, 2007

Last updated

May 9, 2013By 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

Medicare fee-for-service enrollment

Enrolled in FL, IL2 enrollments

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 2

Specialty

Emergency Medicine

Education

Nova Southeastern College of Osteo Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Dupage Emergency Physicians PCGroup PAC ID 5597763706, 37 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
• Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Central Dupage Emergency Physicians, PC

  • Emergency Medicine Physician
  • Winfield, IL
  • NPI 1619074028
  Medicare reassignment Care Compare group
• Emergency Medicine Professionals PA

  • Emergency Medicine Physician
  • Deland, FL
  • NPI 1205880853
  Medicare reassignment NPD

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

• Adventhealth Palm Coast Parkway Inc

  dba Adventhealth Palm Coast Parkway

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1861102345
  Care Compare affiliation
• Memorial Hospital Flagler Inc

  dba AdventHealth Palm Coast

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  dba Northwestern Medicine Central Dupage Hospital

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1942407036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 MAGNOLIA WOODS CT",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320342289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR",
            "address_2": "SUITE 713",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078210",
            "telephone_number": "800-936-5996",
            "fax_number": "904-346-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORJACZEW",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS11252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yale Gordon, DC
• Gore Safe Transportation LLC
• Lacey Nicole Gore, APRN
• Phillip Gore
• Anna Gorelik, M.D.
• Igor Gorky
• Radhakrishna Gorle
• Amanda Leigh Gorlicki, LCSW
• Kimberly Gorman, PA-C
• Ashley Gormely, PT, DPT

• Emergency Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.