Provider Demographics
NPI:1073515292
Name:JANCARIK, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:JANCARIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:AVALON
Mailing Address - State:PA
Mailing Address - Zip Code:15202-2706
Mailing Address - Country:US
Mailing Address - Phone:412-766-3232
Mailing Address - Fax:412-766-1306
Practice Address - Street 1:824 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:AVALON
Practice Address - State:PA
Practice Address - Zip Code:15202-2706
Practice Address - Country:US
Practice Address - Phone:412-766-3232
Practice Address - Fax:412-766-1306
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084464207RN0300X
PAMD074336207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV251423634027OtherMT. STATE BC/BS
7383591OtherAETNA
PA1541459Medicaid
PA245504OtherHEALTH AM./ASSUR.
OH2497981Medicaid
PA1010919060003Medicaid
PA410364OtherUPMC
OH000000337048OtherANTHEM BC/BS
PA1620798OtherHIGHMARK BC/BS
PA000000157621Medicaid
OH2497981Medicaid
PA1010919060003Medicaid
PA1620798OtherHIGHMARK BC/BS
P00149919Medicare ID - Type UnspecifiedRAILROAD MEDICARE