Individual provider Active NPI

Enida Zekovic, PA

  • Emergency Medicine Physician
  • Patchogue, NY
National Provider Identifier
1255858601
Registry record updated Aug 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
021075 Issued in NY
Practice address
101 Hospital Rd
Patchogue, NY 11772-4870
Phone
(631) 654-7100
NPI assigned
Aug 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2017

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 021075 NY Primary

Addresses

Primary practice location

101 Hospital Rd
Patchogue, NY 11772-4870

Mailing address

17 Munson St
Medford, NY 11763-4408
Phone (631) 355-9353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180112000757 NY Practitioner - Physician Assistant 4082973391 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
021075NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Physicians of Suffolk County, PLLC Emergency Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: enida.zekovic@ghuc.eclinicaldirectplus.com

Organizations & group practices 4

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": "1503705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503705600000",
    "number": "1255858601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MUNSON ST",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117634408",
            "telephone_number": "631-355-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL RD",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117724870",
            "telephone_number": "631-654-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEKOVIC",
        "first_name": "ENIDA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-26",
        "last_updated": "2017-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "021075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Patchogue, NY

Sources for this page

Verify at the official NPI Registry.