Custom Family Care, LLC
NPI 1053839811ActiveOrganization· Family Medicine· Madison, AL
Family Medicine in Madison, Alabama, registered in NPPES in August 2017. The authorized official on file is Ivan Pivovarov, MD, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1053839811 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 31, 2017 |
| Last updated in NPPES | Jun 2, 2021 |
| Certified by provider | Jun 2, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
| Clinic/Center, Urgent Care | 261QU0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL) |
|---|
Other Family Medicine providers in Madison
- 1295622017
- 1588864466
- 1720133630
- 1366057986
- 1063896314
- 1508439761
- 1700256252
- 1700476736
- 1114141744
- 1982913463
- 1639376759
- 1497240485