1083631071 NPI number — MAGELLA MEDICAL ASSOCIATES BILLING, INC.

Table of content: ERIN KARKIS LCSW (NPI 1881371391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083631071 NPI number — MAGELLA MEDICAL ASSOCIATES BILLING, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAGELLA MEDICAL ASSOCIATES BILLING, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MAGELLA MEDICAL ASSOCIATES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083631071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1301 CONCORD TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUNRISE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33323-2843
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-243-3829
Provider Business Mailing Address Fax Number:
214-343-2814

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 E PRESIDENT GEORGE BUSH HWY
Provider Second Line Business Practice Location Address:
SUITE 250
Provider Business Practice Location Address City Name:
RICHARDSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75082-3542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-437-5099
Provider Business Practice Location Address Fax Number:
214-343-2814
Provider Enumeration Date:
07/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DWYER
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
ASSISTANT SECRETARY
Authorized Official Telephone Number:
972-437-5099

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080N0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2080P0008X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LN0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0004DJ . This is a "BCBS AUSTIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0096MW . This is a "BCBS CARDI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0098JQ . This is a "BCBS SA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 125998804 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2151688 . This is a "AETNA GROUP SA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 003DJ . This is a "BCBS SA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 125998839 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1518920-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1577629-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5108785 . This is a "AETNA AUSTIN/SA GROUP #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 081018601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 081018602 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0806424-02 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 173248901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0001JV . This is a "BCBS AUSTIN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0022EZ . This is a "BCBS DALLAS MFM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 125998834 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00R87Z . This is a "BCBS AUSTIN/SA CARDI GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0806457-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112890201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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