MEDICARE: JOHN P. JANCARIK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	35084464	OH
2	207RN0300X	Nephrology Physician	MD074336	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	251423634027	OTHER	WV	MT. STATE BC/BS
2	7383591	OTHER		AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	245504	OTHER	PA	HEALTH AM./ASSUR.
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	410364	OTHER	PA	UPMC
8	000000337048	OTHER	OH	ANTHEM BC/BS
9	1620798	OTHER	PA	HIGHMARK BC/BS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073515292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN P. JANCARIK M.D.

Provider Business Mailing Address
First Line	:	824 CALIFORNIA AVE
Second Line	:
City	:	AVALON
State	:	PA
Zip	:	15202-2706
Country	:	US
Telephone Number	:	412-766-3232
Fax Number	:	412-766-1306

Provider Business Practice Location Address
First Line	:	824 CALIFORNIA AVE
Second Line	:
City	:	AVALON
State	:	PA
Zip	:	15202-2706
Country	:	US
Telephone Number	:	412-766-3232
Fax Number	:	412-766-1306

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	01/04/2022

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Directions to “ JOHN P. JANCARIK M.D.” Practice Location

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