Active NPI
Ewa B Marcinkowska, M.D.
- Family Medicine Physician
- Myrtle Beach, SC
National Provider Identifier
1710166053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 24043
- Practice address
- 1752 Highway 501
Myrtle Beach, SC 29577-9750 - Phone
- (843) 448-3050
- Fax
- (843) 448-5934
- NPI assigned
- Nov 2, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 24043 | SC | Primary |
Addresses
Primary practice location
1752 Highway 501
Myrtle Beach, SC 29577-9750
Mailing address
1752 Highway 501
Myrtle Beach, SC 29577-9750
Phone (843) 448-3050
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LL3787 | Medicaid | SC | |
| 7733 | Other | SC | MEDICARE PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2015 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24043 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194393600000",
"number": "1710166053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1752 HIGHWAY 501",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295779750",
"telephone_number": "843-448-3050",
"fax_number": "843-448-5934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1752 HIGHWAY 501",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295779750",
"telephone_number": "843-448-3050",
"fax_number": "843-448-5934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCINKOWSKA",
"first_name": "EWA",
"middle_name": "B",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-02",
"last_updated": "2007-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "24043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "LL3787",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PROVIDER NUMBER",
"identifier": "7733",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Myrtle Beach, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.