JENNIFER ROSE DEFAZIO M.D.
NPI 1235441429
Surgery - Pediatric Surgery in Chicago, IL

Q: What is Jennifer Defazio's NPI number?

The NPI number for Jennifer Defazio is 1235441429. It was assigned to this individual provider in the NPPES registry on July 5, 2010. The provider is also known as Jennifer Rose Miksan.

Q: What is Jennifer Defazio's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Pediatric Surgery, with taxonomy code 2086S0120X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Defazio was last updated on January 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 05, 2010PECOS Enrolled

100/100

CMS Quality Rating

5841 S MARYLAND AVE, CHICAGO, IL 60637(773) 702-1000 Get Directions Write a Review

NPPES record last updated: January 23, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Jennifer Rose Defazio M.d. NPPES

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

JENNIFER ROSE DEFAZIO M.D. (NPI 1235441429) is an individual pediatric surgery provider in Chicago, Illinois, licensed in New York (288868-1) and active in the NPI registry since July 2010. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1235441429

Entity TypeIndividualFemale

Primary Taxonomy2086S0120X

Provider Legal NameJENNIFER ROSE DEFAZIOCredential: M.D.

Location Address5841 S MARYLAND AVEChicago, IL 60637-1447

Mailing Address3959 Broadway Rm 216bNew York, NY 10032-1559

Phone(773) 702-1000

Sole ProprietorYes

Enumeration DateJuly 5, 2010

Last NPPES UpdateJanuary 23, 2020

✔ NPI 1235441429 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Pediatric SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0120X

License✔ Licensed in NY · 288868-1

Definition

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

5841 S MARYLAND AVE, Chicago, IL 60637

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Other Names 1

Former Name (1)Jennifer Rose Miksan

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jennifer Rose Defazio M.d. 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

86.8

Promoting Interoperability

100

Improvement Activities

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.

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