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JUSTIN CHEDIAK MD
NPI 1174226195
Student in an Organized Health Care Education/Training Program in Phoenix, AZ

Active since March 27, 2023PECOS Enrolled
1300 N 12TH ST STE 605, PHOENIX, AZ 85006(602) 521-5969 Get Directions Write a Review

NPPES record last updated: March 27, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Justin Chediak Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JUSTIN CHEDIAK MD (NPI 1174226195) is an individual student in an organized health care education/training program in Phoenix, Arizona and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174226195
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJUSTIN CHEDIAKCredential: MD
Location Address1300 N 12TH ST STE 605Phoenix, AZ 85006-2850
Mailing Address151 Du Rhu Dr Apt 1205Mobile, AL 36608-1268
Phone(602) 521-5969
Sole ProprietorYes
Enumeration DateMarch 27, 2023
NPPES CertifiedMarch 27, 2023
✔ NPI 1174226195 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1300 N 12TH ST STE 605, Phoenix, AZ 85006
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Justin Chediak Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYERRA N LEA
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567
DR. CAITLIN MOLLOY LEE D.O.
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-2668
B--UMCP PRIMARY CARE PHYSICIANS LLC
Clinic/Center (Multi-Specialty)
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567
AMBER REESE PORTER DNP, FNP
Nurse Practitioner (Family)
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567
KATY ANNE KIRK MD, MPH
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-2668
HEATHER MERCHUT
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567
CLAYTON TIMOTHY PIERCE
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567
ANDREW JOSEPH OCHOA
Family Medicine
1300 N 12TH ST STE 605
PHOENIX, AZ 85006
Maricopa County (602) 839-4567

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Justin Chediak's NPI number?

The NPI number for Justin Chediak is 1174226195. It was assigned to this individual provider in the NPPES registry on March 27, 2023.

Where is Justin Chediak located?

Justin Chediak practices at 1300 N 12th St Ste 605, Phoenix, AZ 85006. The listed phone number is (602) 521-5969.

What is Justin Chediak's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Justin Chediak enrolled in Medicare?

Yes. Justin Chediak is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Justin Chediak was last updated on March 27, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.