Kurtis Dejong, MD | |
5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545-1469 | |
(574) 335-5000 | |
Not Available |
Full Name | Kurtis Dejong |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 5215 Holy Cross Pkwy, Mishawaka, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184680159 | NPI | - | NPPES |
930102831 | Other | IN | RAIL ROAD MEDICARE |
104943838 | Medicaid | MI | |
000000190295 | Other | IN | ANTHEM |
200022520 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207PE0004X | Emergency Medicine - Emergency Medical Services | 01039621 (Indiana) | Secondary |
207P00000X | Emergency Medicine | 01039621 (Indiana) | Primary |
Entity Name | Elite Emergency Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932155371 PECOS PAC ID: 8022087642 Enrollment ID: O20040930000456 |
Mailing Address | Practice Location Address |
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Kurtis Dejong, MD 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545-1469 Ph: (574) 335-5000 | Kurtis Dejong, MD 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545-1469 Ph: (574) 335-5000 |
Dr. Christy Lynn Annis, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Kathleen Long, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Dr. Eugene Huang, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 E Day Rd, Mishawaka, IN 46545 Phone: 574-204-7243 Fax: 574-226-0795 | |
Jonathan Neil Shenk, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Mark Lawrence Kricheff, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 | |
Karla Goulart Newbold, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5215 Holy Cross Pkwy, Emergency Department, Mishawaka, IN 46545 Phone: 574-335-5000 |