Individual provider Active NPI

Maria J Tomczyk, MD

  • Family Medicine Physician
  • Cleveland, TN
National Provider Identifier
1497710040
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD29153 Issued in TN
Practice address
1060 William Way NW
Cleveland, TN 37312-4369
Phone
(423) 478-1050
Fax
(423) 478-1075
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 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 MD29153 TN Primary

Addresses

Primary practice location

1060 William Way NW
Cleveland, TN 37312-4369

Mailing address

165 Covington Dr NE
Cleveland, TN 37312-4792
Phone (423) 478-1050

Other identifiers 1

IdentifierTypeStateIssuer
3814352MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050817000239 TN Practitioner - Family Practice 1456381698 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD29153TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Medical Associates, PLLC Family Medicine CurrentSince Sep 1, 2005 Accepting new patients
Cleveland Medical Clinic Inc Past Accepting new patients

Locations

1060 William Way NW
Cleveland, TN 37312
Phone (423) 475-1050

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EEIHBD

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": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1497710040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COVINGTON DR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124792",
            "telephone_number": "423-478-1050",
            "fax_number": "423-478-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 WILLIAM WAY NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124369",
            "telephone_number": "423-478-1050",
            "fax_number": "423-478-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMCZYK",
        "first_name": "MARIA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD29153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3814352",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.