Myron Fribush, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

5255 Issued in AK

Practice address

209 Moller Ave
Mountainside Family Healthcare
Sitka, AK 99835-7142

Phone

(907) 747-1722

Fax

(907) 747-1755

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, AK2 enrollments

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 2

Specialty

Family PracticeAlso: Geriatric Medicine

Education

University of Rochester School of Medicine and Dentistry, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cordova Community Medical CenterGroup PAC ID 1759275902, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cordova Community Medical Center Hospital, Cordova, AK, CCN 021307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/cordova-527880fe
• Direct secure messaging: myronf@direct-searhc.org

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.

• Cordova Community Medical Center

  • Critical Access Hospital
  • Cordova, AK
  • NPI 1215035787

  AK

  Medicare reassignment Care Compare group NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Thorne Bay, AK
  • NPI 1376758037

  TX

  Medicare reassignment NPD
• Winslow Indian Health Care Center, Inc

  • Federal Public Health Clinic/Center
  • Winslow, AZ
  • NPI 1184729493

  TX

  Medicare reassignment NPD
• South East Alaska Regional Health Consortium

  • Clinic/Center
  • Kasaan, AK
  • NPI 1962616821
  NPD
• Southeast Alaska Regional Health Consortium

  • Clinic/Center
  • Juneau, AK
  • NPI 1427941343
  NPD
• Southeast Alaska Regional Health Consortium

  • Critical Access Hospital
  • Sitka, AK
  • NPI 1720062524
  NPD
• Winslow Indian Health Care Center, Inc

  • Land Ambulance
  • Winslow, AZ
  • NPI 1477827368
  NPD
• Native Village of Eyak

  • Clinic/Center
  • Cordova, AK
  • NPI 1134471287
  NPD (past)
• South East Alaska Regional Health Consortium

  • Clinic/Center
  • Hydaburg, AK
  • NPI 1073728168
  NPD (past)
• South East Alaska Regional Health Consortium

  • Clinic/Center
  • Wrangel, AK
  • NPI 1487836391
  NPD (past)
• Hospitalist Healthcare Services PLLC

  • Internal Medicine Physician
  • White Plains, NY
  • NPI 1902224520

  Geriatric Medicine

  NPD (past)
• Provident Emergency Medicine Associates, PC

  • Emergency Medicine Physician
  • Schenectady, NY
  • NPI 1750310645
  NPD (past)

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

• Cordova Community Medical Center

  • Critical Access Hospital
  • Cordova, AK
  • NPI 1215035787

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1184702102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MOLLER AVE",
            "address_2": "MOUNTAINSIDE FAMILY HEALTHCARE",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357142",
            "telephone_number": "907-747-1722",
            "fax_number": "907-747-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MOLLER AVE",
            "address_2": "MOUNTAINSIDE FAMILY HEALTHCARE",
            "city": "SITKA",
            "state": "AK",
            "postal_code": "998357142",
            "telephone_number": "907-747-1722",
            "fax_number": "907-747-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIBUSH",
        "first_name": "MYRON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AK",
            "license": "5255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD4646",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrell Wayne Ford
• Heather A Ford, LMT
• Laiwun Ford
• Georgianna Foruria, RN
• Jeanette Marie Foss, RN
• Anthony Fuller
• Susan Fuller, RN
• John Robert Fulton, PHARM.D
• Kristine Sundquist Fulton, RPH
• Leslie Fulton

• All providers in Sitka, AK
• Geriatric Medicine (Family Medicine) Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.