Individual provider Active NPI

Edward Carl Huycke, MD

  • Cardiovascular Disease Physician
  • Washington, DC
National Provider Identifier
1215904826
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
04-18243 Issued in KS
Practice address
Department of Veterans Affairs
810 Vermont Ave, NW
Washington, DC 20420-0001
Phone
(202) 273-5806
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 04-18243 KS Primary

Addresses

Primary practice location

Department of Veterans Affairs
810 Vermont Ave, NW
Washington, DC 20420-0001

Mailing address

3017 N Nottingham St
Arlington, VA 22207-1269
Phone (202) 273-5806

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
I20200622002715 VA Practitioner - Internal MedicinePractitioner - Addiction Medicine 4880016732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Kansas City College of Medicine and Surgery, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7969 Ashton Ave
Manassas, VA 20109-2885
Phone (703) 792-7800

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-18243KSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prince William County Community Services Board CurrentSince Mar 18, 2020 Accepting new patients
Prince William County CurrentSince Mar 18, 2020 Accepting new patients

Locations

7969 Ashton Ave
Manassas, VA 20109
Phone (703) 792-7826

14011 Worth Ave
Ste 110
Woodbridge, VA 22192

Organizations & group practices 2

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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1215904826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 N NOTTINGHAM ST",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222071269",
            "telephone_number": "202-273-5806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF VETERANS AFFAIRS",
            "address_2": "810 VERMONT AVE, NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "204200001",
            "telephone_number": "202-273-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUYCKE",
        "first_name": "EDWARD",
        "middle_name": "CARL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KS",
            "license": "04-18243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.