Individual provider Active NPI

Edward J Markushewski, MD

  • Emergency Medicine Physician
  • Huntsville, AL
National Provider Identifier
1568457208
Registry record updated Feb 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00009917 Issued in AL
Practice address
101 Sivley Rd SW
Em Dept
Huntsville, AL 35801-4421
Phone
(256) 265-9905
Fax
(256) 265-9910
NPI assigned
Sep 19, 2005
Last updated
Feb 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2010

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 00009917 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Em Dept
Huntsville, AL 35801-4421

Mailing address

PO Box 11407
Drawer 0314
Birmingham, AL 35246-0314
Phone (405) 751-4664

Other identifiers 4

IdentifierTypeStateIssuer
000027874MedicaidAL
4275384OtherALAETNA
051027874OtherALBCBS
009936322MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20111213000514 AL Practitioner - Emergency Medicine 4284809625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians GroupGroup PAC ID 5496669350, 47 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-9889

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00009917ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Group Emergency Medicine CurrentSince Jan 22, 1997 Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1568457208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "address_2": "DRAWER 0314",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352460314",
            "telephone_number": "405-751-4664",
            "fax_number": "405-749-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "address_2": "EM DEPT",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-9905",
            "fax_number": "256-265-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKUSHEWSKI",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00009917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000027874",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4275384",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051027874",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009936322",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.