Individual provider Active NPI

Donald J Kushon, MD

  • Psychiatry Physician
  • Fairbanks, AK
National Provider Identifier
1730174756
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD042233E Issued in PA
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

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071120000133 PA Practitioner - Psychiatry 5597747261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042233EPAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Drexel University CurrentSince Jul 1, 2014 Accepting new patients
Drexel University CurrentSince Jul 1, 2014 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.

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

Verify at the official NPI Registry.