Individual provider Active NPI

Elizabeth Mairi Csukker

  • Student in an Organized Health Care Education/Training Program
  • Berea, OH
National Provider Identifier
1285346163
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
275 Eastland Rd
Berea, OH 44017-2005
Phone
(440) 826-8012
NPI assigned
Dec 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

275 Eastland Rd
Berea, OH 44017-2005

Mailing address

275 Eastland Rd
Berea, OH 44017-2005
Phone (440) 826-8012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20241007000465 OR Practitioner - Physician Assistant 4082145701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Peaks Health Care, LLCGroup PAC ID 9739460148, 3 clinicians

Practice addresses (Care Compare)

1555 SW Reindeer Ave
Redmond, OR 97756-9449
Phone (541) 548-4088

415 1St St
Fossil, OR 97830-8292
Phone (541) 548-4088

Hospital & facility affiliations

  • St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047
  • St Charles Madras Hospital, Madras, OR, CCN 381324
  • St Charles Medical Center Prineville Hospital, Prineville, OR, CCN 381313

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: elizabeth.csukker.1@14996.direct.athenahealth.com

Organizations & group practices 1

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 4

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": "1671667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1285346163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005",
            "telephone_number": "440-826-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440172005",
            "telephone_number": "440-826-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CSUKKER",
        "first_name": "ELIZABETH",
        "middle_name": "MAIRI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-22",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.