Individual provider Active NPI

Marc Elliott Kushinka, M.D.

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1174972509
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
39482 Issued in SC
Practice address
2435 Forest Dr
Columbia, SC 29204-2026
Phone
(803) 256-5300
NPI assigned
Jun 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 39482 SC Primary

Addresses

Primary practice location

2435 Forest Dr
Columbia, SC 29204-2026

Mailing address

PO Box 935722
Atlanta, GA 31193-5722
Phone (803) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
394825MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20190117003995 SC Practitioner - Emergency Medicine 5799021333 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39482SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Emergency Medicine Current Accepting new patients
Prisma Health-Midlands Current Accepting new patients
McLeod Health Cheraw Emergency Medicine CurrentSince Aug 25, 2018 Accepting new patients
McLeod Health Cheraw CurrentSince Aug 25, 2018 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 1, 2021 Accepting new patients
Musc Community Physicians CurrentSince Dec 9, 2021 Accepting new patients
Prisma Health-Midlands Emergency Medicine CurrentSince Jul 1, 2019 Accepting new patients
Musc Community Physicians CurrentSince Dec 9, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 1, 2021 Accepting new patients
Musc Community Physicians Emergency Medicine Current Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

1330 Taylor St
Ste 100
Columbia, SC 29201
Phone (803) 434-6410

400 Palmetto Health Pkwy
Columbia, SC 29212
Phone (803) 296-5579

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: mkushinka380601@direct.musc.edu
  • Direct secure messaging: mkushinka413116@direct.ghs.myhfn.org

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1174972509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935722",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935722",
            "telephone_number": "803-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 FOREST DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042026",
            "telephone_number": "803-256-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHINKA",
        "first_name": "MARC",
        "middle_name": "ELLIOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-07",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "39482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "394825",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2435 Forest Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292042026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.