Active NPI
Marc Stuart Zelickson, M.D.
- Surgery Physician
- Huntsville, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 32718
- Practice address
- 4025 Pepperwood Cir SW
Suite C
Huntsville, AL 35801-7437 - Phone
- (256) 882-1908
- Fax
- (256) 882-1907
- NPI assigned
- Jun 6, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 32718 | AL | Primary |
Addresses
Primary practice location
4025 Pepperwood Cir SW
Suite C
Huntsville, AL 35801-7437
Mailing address
PO Box 2705
Suite C
Huntsville, AL 35804-2705
Phone (256) 265-5951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 150521 | Medicaid | AL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Alabama School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1041 Balch Rd
Suite 350
Madison, AL 35758-8822
Phone (256) 265-6851
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 12 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32718 | AL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HH Physicians Network | Current | Accepting new patients | |
| Dennis L Fernandez MD PC | Surgery | Past | Accepting new patients |
Locations
201 Governors Dr SW
Huntsville, AL 35801
Phone (256) 265-6851
101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870
201 Sivley Rd SW
Ste 330
Huntsville, AL 35801
Phone (256) 265-1910
245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673
8371 Highway 72 W
Ste 206
Madison, AL 35758
Phone (256) 265-5640
1041 Balch Rd
Ste 350
Madison, AL 35758
Phone (256) 265-5951
8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012
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.
-
- Specialist
- Huntsville, AL
- NPI 1891359683
-
- Surgery Physician
- Huntsville, AL
- NPI 1639396187
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Huntsville Hospital
- General Acute Care Hospital
- Huntsville, AL
- NPI 1447221056
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467244800000",
"number": "1649439472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2705",
"address_2": "SUITE C",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358042705",
"telephone_number": "256-265-5951",
"fax_number": "256-265-5952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4025 PEPPERWOOD CIR SW",
"address_2": "SUITE C",
"city": "HUNTSVILLE",
"state": "AL",
"postal_code": "358017437",
"telephone_number": "256-882-1908",
"fax_number": "256-882-1907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZELICKSON",
"first_name": "MARC",
"middle_name": "STUART",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-06",
"last_updated": "2016-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "32718",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "150521",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Huntsville, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.