Individual provider Active NPI

Marc Stuart Zelickson, M.D.

  • Surgery Physician
  • Huntsville, AL
National Provider Identifier
1649439472
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
32718 Issued in AL
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

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
150521MedicaidAL

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
I20130807000513 AL Practitioner - General Surgery 7012165889 Reassigns benefits to 1 organization

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
HH Physicians NetworkGroup PAC ID 6901132448, 107 clinicians

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

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)12
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32718ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HH Physicians Network CurrentSince Jul 1, 2020 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.

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": "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

Verify at the official NPI Registry.