Ewa Antonczyk, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

46834 Issued in TN

Practice address

647 Dunlop LN
Suite 108
Clarksville, TN 37040-5165

Phone

(931) 502-3660

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

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

Internal Medicine

Education

University of Miami, LM Miller School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clarksville Physician Services, LLCGroup PAC ID 0547276917, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vanderbilt Clarksville Hospital Hospital, Clarksville, TN, CCN 440035

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/1879/brand/1/csg/1/fhir/r4
• Direct secure messaging: ewa.antonczyk.1@1879.direct.athenahealth.com
• Direct secure messaging: eantonczyk@direct-address.org

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.

• Clarksville Physician Services LLC

  • General Practice Physician
  • Clarksville, TN
  • NPI 1083657829

  TN

  Medicare reassignment Care Compare group NPD
• Clarksville Physician Services, LLC

  • Rural Health Clinic/Center
  • Dover, TN
  • NPI 1992077077
  Care Compare group NPD (past)
• Tennessee Heart and Lung Institute PLC

  • Specialist
  • Clarksville, TN
  • NPI 1699802371
  NPD (past)

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

• Clarksville Health System, LLC

  • General Acute Care Hospital
  • Clarksville, TN
  • NPI 1285689794

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1891740270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN",
            "address_2": "SUITE 108",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN",
            "address_2": "SUITE 108",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "931-502-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONCZYK",
        "first_name": "EWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2005-0482",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "46834",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME93992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ewa.antonczyk.1@1879.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "647 Dunlop Ln",
            "address_2": "Suite 108",
            "city": "Clarksville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370405165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anil Patel, MD PC
• Animal Clinic of North Clarksville
• Anthony V. Perry O.D. & Associates PLC
• Anthony V. Perry O.D. & Associates PLC
• Gus Antoine Sr.
• Elizabeth Apelt
• Apothecary Associates Inc
• Apria Healthcare LLC
• Barbara A Aquino, MD
• Ramon Jongo Aquino, M.D.

• All providers in Clarksville, TN
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.