Individual provider Active NPI

Maciej Tymowski, MD

  • Emergency Medicine Physician
  • Richmond, VA
National Provider Identifier
1073581963
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101235666 Issued in VA
Practice address
1250 E Marshall St
Emergency Department
Richmond, VA 23298-5051
Phone
(804) 828-7738
Fax
(804) 828-4686
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21345 WV
Emergency Medicine Physician 207P00000X 0101235666 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Emergency Department
Richmond, VA 23298-5051

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Other identifiers 1

IdentifierTypeStateIssuer
0101235666OtherVALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20041105000139 VA Practitioner - Emergency Medicine 8325935687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1250 E Marshall St
Richmond, VA 23219-5051
Phone (804) 828-9000

Hospital & facility affiliations

  • Medical College of Virginia Hospitals Hospital, Richmond, VA, CCN 490032

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101235666VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Emergency Medicine CurrentSince Dec 2, 2007 Accepting new patients
Long Point Emergency Physicians LLC Past Accepting new patients
West Virginia Em-I Medical Services Emergency Medicine Past Accepting new patients
Virginia Em-I Medical Services, PC Emergency Medicine Past Accepting new patients
Virginia Emergency Group LLC Emergency Medicine Past Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

401 N 12th St
Richmond, VA 23298
Phone (804) 628-6975

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1073581963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "address_2": "EMERGENCY DEPARTMENT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985051",
            "telephone_number": "804-828-7738",
            "fax_number": "804-828-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYMOWSKI",
        "first_name": "MACIEJ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "21345",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101235666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0101235666",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.