Individual provider Active NPI

Michael Armen Ekizian, M.D.

  • General Practice Physician
  • Uniontown, PA
National Provider Identifier
1063779742
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD438929 Issued in PA
Practice address
630 Cherry Tree LN
Uniontown, PA 15401-8947
Phone
(724) 439-0308
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD438929 PA Primary

Addresses

Primary practice location

630 Cherry Tree LN
Uniontown, PA 15401-8947

Mailing address

12202 Clearfork Dr
Houston, TX 77077-2513
Phone (281) 870-9394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240208003248 PA Order and Referring Only - General PracticePractitioner - General Practice 2466707542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD438929PAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Windber Hospital, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1063779742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12202 CLEARFORK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770772513",
            "telephone_number": "281-870-9394",
            "fax_number": "281-589-9275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 CHERRY TREE LN",
            "city": "UNIONTOWN",
            "state": "PA",
            "postal_code": "154018947",
            "telephone_number": "724-439-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKIZIAN",
        "first_name": "MICHAEL",
        "middle_name": "ARMEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD438929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Uniontown, PA

Sources for this page

Verify at the official NPI Registry.