ETHAN MARK HUCKABEE (DO) – Emergency Medicine Physician, NPI 1043705395
Emergency Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
3,157 EMERGENCY MEDICINE in MI
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Provider Addresses for ETHAN MARK HUCKABEE (DO)
405 W JACKSON ST
CARBONDALE, IL 629011462
Phone: (618) 549-0721
Fax: (618) 457-0469
Type: Mailing
205, East Avenue, Grass Lake, Grass Lake Township, Jackson County, Michigan, 49240, United States
JACKSON, MI 492011753
Phone:
Type: Mailing
939 Caroline St
Port Angeles, WA 983623997
Phone: (360) 417-7000
Fax: (360) 565-9241
Type: Location
1000 Health Center Dr
Mattoon, IL 619384644
Phone: (217) 258-2551
Type: Location
201 S 14th St
Herrin, IL 629483631
Phone: (618) 942-2171
Type: Location
2 S Hospital Dr
Murphysboro, IL 629663333
Phone: (618) 684-3156
Type: Location
PO BOX 850
PORT ANGELES, WA 983620146
Phone: (360) 417-7111
Fax: (360) 417-7342
Type: Mailing
939 CAROLINE ST
PORT ANGELES, WA 983623997
Phone: (360) 417-7000
Fax: (360) 565-9241
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $54.
Total Amount is formed as General ($54) + Research ($0) + Ownership ($0) = $54.
Last reported payment date: 2024-10-21 • Largest payer in this snapshot: ABBVIE INC. ($54).
Total Amount
$54
General + Research + Ownership
Payments
2
Total payment records
General Amount
$54
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $54 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-12-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221201003062 | I | Emergency Medicine | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 312 | 305 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 157 | 152 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 88 | 78 | $0 |
| 99291 | Critical care, first 30-74 minutes | 30 | 29 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 11 | 11 | $0 |
Insurance plans in this area (ZIP 62901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| H E M A T O L O G Y/ O N C O L O G Y | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| - | IL | |
| Nurse Practitioner | MO | |
| Nurse Practitioner | IL | |
| Emergency Medicine | IL | |
| - | IL | |
| N E U R O L O G Y | IL | |
| U R O L O G Y | IL | |
| General Surgery | IL |
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