Marc Mickiewicz, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD37402 Issued in TN

Practice address

6746 Charlotte Pike
Nashville, TN 37209

Phone

(615) 647-9005

NPI assigned

Oct 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency MedicineAlso: Anesthesiology, Pediatric Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians at Sumner PLLCGroup PAC ID 2062434160, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Highpoint Health-Sumner With Ascension Saint Thoma Hospital, Gallatin, TN, CCN 440003

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marc.mickiewicz.1@25094.direct.athenahealth.com

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.

• Emergency Physicians at Sumner PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Gallatin, TN
  • NPI 1538149521
  Medicare reassignment Care Compare group NPD
• Privia Medical Group Tennessee LLC

  • Family Medicine Physician
  • Nashville, TN
  • NPI 1376110858
  Medicare reassignment NPD
• Privia Medical Group Tennessee LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Nashville, TN
  • NPI 1215694229
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sumner Regional Medical Center LLC

  • General Acute Care Hospital
  • Gallatin, TN
  • NPI 1447571658
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1710074828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4608 INDIANA AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372092328",
            "telephone_number": "615-604-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6746 CHARLOTTE PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37209",
            "telephone_number": "615-647-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKIEWICZ",
        "first_name": "MARC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD37402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew A Michel, M.D.
• Benjamin Michel, FNP-BC
• Donna L Michel
• Xiaoxia Michelson, NP
• Michigan Iom, LLC.
• Marcy Mickiewicz, APRN
• Mid Cumberland Community Services Agency
• Mid South Anesthesia PC
• Mid State Oncology& Hematology
• Mid Tennessee Neonatology Associates PC

• Emergency Medicine Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Emergency Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.

Verify at the official NPI Registry.