Active NPI
Donald J Kushon, MD
- Psychiatry Physician
- Fairbanks, AK
National Provider Identifier
1730174756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD042233E
- Practice address
- 1650 Cowles St
Fairbanks Memorial Hospital
Fairbanks, AK 99701-5925 - Phone
- (907) 458-5525
- Fax
- (907) 458-5514
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD042233E | PA | Primary |
Addresses
Primary practice location
1650 Cowles St
Fairbanks Memorial Hospital
Fairbanks, AK 99701-5925
Mailing address
1601 Cherry St
Suite 11511
Phila, PA 19102-1320
Phone (215) 255-7822
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD042233E | PA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drexel University | Current | Accepting new patients | |
| Drexel University | Current | Accepting new patients | |
| Drexel University | Current | Accepting new patients | |
| Scott a. Fleischer, M.D., P.C. | Psychiatry | Past | Accepting new patients |
Locations
1427 Vine St
Fl 8
Philadelphia, PA 19102
Phone (215) 762-6660
1601 Cherry St
Ste 11511
Philadelphia, PA 19102
1427 Vine St
Fl 2
Philadelphia, PA 19102
Phone (215) 762-2530
Organizations & group practices 4
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.
-
- Psychologist
- Philadelphia, PA
- NPI 1902900095
-
- Audiologist
- Elkins Park, PA
- NPI 1104822253
-
- Oral and Maxillofacial Surgery (Dentist)
- Philadelphia, PA
- NPI 1700981180
-
- Psychiatry Physician
- Fort Washington, PA
- NPI 1720181720
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463011200000",
"number": "1730174756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CHERRY ST",
"address_2": "SUITE 11511",
"city": "PHILA",
"state": "PA",
"postal_code": "191021320",
"telephone_number": "215-255-7822",
"fax_number": "215-255-7825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 COWLES ST",
"address_2": "FAIRBANKS MEMORIAL HOSPITAL",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015925",
"telephone_number": "907-458-5525",
"fax_number": "907-458-5514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSHON",
"first_name": "DONALD",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2016-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD042233E",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.