Individual provider Active NPI

Rossitza Emilova Hristoskova, MD

  • Family Medicine Physician
  • Bentonville, AR
National Provider Identifier
1477501518
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E3964 Issued in AR
Practice address
1000 SE 13TH Court
Bentonville, AR 72712
Phone
(479) 273-9056
Fax
(479) 273-6937
NPI assigned
May 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E3964 AR Primary

Addresses

Primary practice location

1000 SE 13TH Court
Bentonville, AR 72712

Mailing address

1000 SE 13TH Court
Bentonville, AR 72712
Phone (479) 273-9056

Other identifiers 1

IdentifierTypeStateIssuer
154232001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040626000079 AR Practitioner - Family Practice 2567448954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, 314 clinicians

Practice addresses (Care Compare)

1000 SE 13TH CT
Bentonville, AR 72712-7857
Phone (479) 273-9056

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Rogers, AR, CCN 047149
  • Circle of Life Hospice Hospice, Springdale, AR, CCN 041529
  • Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
  • Northwest Medical Center-Springdale Hospital, Springdale, AR, CCN 040022

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 1, 2004 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Sep 1, 2004 Accepting new patients
Mercy Health Northwest Arkansas Communities Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

1000 SE 13th Ct
Bentonville, AR 72712
Phone (479) 273-9056

Interoperability endpoints

  • Direct secure messaging: rhristoskova17175@directc.mercy.net

Organizations & group practices 3

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316822400000",
    "number": "1477501518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 SE 13TH COURT",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-273-9056",
            "fax_number": "479-273-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SE 13TH COURT",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "72712",
            "telephone_number": "479-273-9056",
            "fax_number": "479-273-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRISTOSKOVA",
        "first_name": "ROSSITZA",
        "middle_name": "EMILOVA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E3964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154232001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

Verify at the official NPI Registry.