NPIMap

Individual provider Active NPI

Selma Kominek, MD

  • Neurological Surgery Physician
  • Johnson City, TN
National Provider Identifier
1750518544
Registry record updated Oct 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
52473 Issued in TN
Practice address
701 Med Tech Pkwy
Suite 300
Johnson City, TN 37604-2365
Phone
(423) 232-8301
Fax
(423) 232-8304
NPI assigned
Jun 18, 2009
Last updated
Oct 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 52473 TN Primary

Addresses

Primary practice location

701 Med Tech Pkwy
Suite 300
Johnson City, TN 37604-2365

Mailing address

701 Med Tech Pkwy
Suite 300
Johnson City, TN 37604-2365
Phone (423) 232-8301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812009222 TN Practitioner - Neurosurgery 3577784925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Alabama School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

444 Clinchfield St
Suite 103
Kingsport, TN 37660-3859
Phone (423) 578-1518

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion52
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)42

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Mangement Corporation CurrentSince Jul 1, 2018 Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jul 1, 2018 Accepting new patients
Blue Ridge Medical Management Corporation Past Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

701 Med Tech Pkwy
Ste 300
Johnson City, TN 37604
Phone (423) 232-8301

444 Clinchfield St
Ste 103
Kingsport, TN 37660
Phone (423) 548-1518

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1750518544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "address_2": "SUITE 300",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042365",
            "telephone_number": "423-232-8301",
            "fax_number": "423-232-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY",
            "address_2": "SUITE 300",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042365",
            "telephone_number": "423-232-8301",
            "fax_number": "423-232-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMINEK",
        "first_name": "SELMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TN",
            "license": "52473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.