Individual provider Active NPI

Michele Ann Pashkevich, MD

  • Family Medicine Physician
  • Pine Bluff, AR
National Provider Identifier
1659319879
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C7202 Issued in AR
Practice address
1708 W 42ND
Pine Bluff, AR 71603
Phone
(870) 536-7300
Fax
(870) 535-7858
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 C7202 AR Primary

Addresses

Primary practice location

1708 W 42ND
Pine Bluff, AR 71603

Mailing address

1708 W 42ND
Pine Bluff, AR 71603
Phone (870) 536-7300

Other identifiers 1

IdentifierTypeStateIssuer
113183001MedicaidAR

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
I20110317000455 AR Practitioner - Family Practice 1951584655 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C7202ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson Hospital Association Inc CurrentSince Sep 1, 1989 Accepting new patients
Michele a Pashkevich MD PA Family Medicine CurrentSince Jun 17, 1993 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 1, 2015 Accepting new patients
Jefferson Hospital Association, Inc Family Medicine CurrentSince Sep 1, 1989 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 1, 2015 Accepting new patients

Locations

1708 W 42nd Ave
Pine Bluff, AR 71603
Phone (870) 536-7300

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

Organizations & group practices 5

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1659319879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 W 42ND",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-536-7300",
            "fax_number": "870-535-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 W 42ND",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-536-7300",
            "fax_number": "870-535-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASHKEVICH",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C7202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113183001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

Verify at the official NPI Registry.