Individual provider Active NPI

Augusta L Czysz, MD

  • Emergency Medicine Physician
  • Eglin Afb, FL
National Provider Identifier
1295781789
Registry record updated Sep 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
227851 Issued in MA
Practice address
307 Boatner Rd
Ste 114
Eglin Afb, FL 32542-1391
Phone
(850) 883-8227
Fax
(850) 883-9090
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2009

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 227851 MA Primary

Addresses

Primary practice location

307 Boatner Rd
Ste 114
Eglin Afb, FL 32542-1391

Mailing address

307 Boatner Rd
Ste 114
Eglin Afb, FL 32542-1391
Phone (850) 883-8227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20130521000060 PA Practitioner - Emergency Medicine 8224276829 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
227851MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Conemaugh Memorial Medical Center LLC CurrentSince Sep 6, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Jan 21, 2018 Accepting new patients
DLP Conemaugh Physician Practices LLC Current Accepting new patients
DLP Conemaugh Memorial Medical Center LLC Current Accepting new patients
DLP Conemaugh Memorial Medical Center LLC Emergency Medicine CurrentSince Sep 6, 2014 Accepting new patients
DLP Conemaugh Physician Practices LLC CurrentSince Jan 21, 2018 Accepting new patients

Locations

1086 Franklin St
Bldg G
Johnstown, PA 15905
Phone (914) 534-9000

1111 Franklin St
Ste 180
Johnstown, PA 15905
Phone (814) 534-3740

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

Organizations & group practices 6

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1295781789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "address_2": "STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8227",
            "fax_number": "850-883-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD",
            "address_2": "STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421391",
            "telephone_number": "850-883-8227",
            "fax_number": "850-883-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZYSZ",
        "first_name": "AUGUSTA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "227851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eglin Afb, FL

Sources for this page

Verify at the official NPI Registry.