NPIMap

Individual provider Active NPI

Alexander Vdovenko, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New Britain, CT
National Provider Identifier
1003874686
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
39677 Issued in CT
Practice address
100 Grand St
New Britain, CT 06052-2016
Phone
(860) 224-5584
Fax
(860) 224-5946
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Pathology Associates PC 29 clinicians

Practice addresses (Care Compare)

80 Seymour St
Pathology Dept
Hartford, CT 06141-0540
Phone (860) 545-2249

Hospital & facility affiliations

  • The Hospital of Central Connecticut Hospital, New Britain, CT, CCN 070035
  • Charlotte Hungerford Hospital Hospital, Torrington, CT, CCN 070011
  • Hartford Hospital Hospital, Hartford, CT, CCN 070025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070213000548 CT Practitioner - Pathology 1456353952 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
39677CTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Pathology Associates, P.C. Anatomic Pathology & Clinical Pathology CurrentSince Feb 2, 2017 Accepting new patients
Hartford Hospital Current Accepting new patients
Hartford Hospital Current Accepting new patients
Northeast Medical Group, Inc. Past Accepting new patients
Urological Associates of Bridgeport Prof.Corp. Past Accepting new patients

Locations

80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249

100 Retreat Ave
Ste 100
Hartford, CT 06106
Phone (860) 545-9050

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

540 Litchfield St
Torrington, CT 06790
Phone (860) 496-6361

Interoperability endpoints

  • Direct secure messaging: alexandrea.vdovenko@xdr.hhchealthdirect.org

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 39677 CT Primary

Addresses

NPPES NPI Registry

Primary practice location

100 Grand St
New Britain, CT 06052-2016

Mailing address

PO Box 1730
New Haven, CT 06507-1730
Phone (203) 397-8000

Other practice location 1

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 282-0833

Other identifiers 11

NPPES NPI Registry
IdentifierTypeStateIssuer
0007210291OtherCTAETNA USHC
061557734OtherCTOXFORD GROUP#
0V6399OtherCTHEALTHNET GROUP#
615577OtherCTCONNECTICARE GRP#
001396771MedicaidCT
500HBL433CT01OtherCTBC/BS NBG GRP#
004199057P1OtherCTBLUE CARE NBG GRP#
500HBL433CT02OtherCTBC/BS BMH GRP#
9094684OtherCTCIGNA
004199057P2OtherCTBLUE CARE BMH GRP#
1104295OtherCTUNITED HEALTHCARE GRP#

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 4, 2018.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1003874686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1730",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065071730",
            "telephone_number": "203-397-8000",
            "fax_number": "203-389-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAND ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060522016",
            "telephone_number": "860-224-5584",
            "fax_number": "860-224-5946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-282-0833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VDOVENKO",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CT",
            "license": "39677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA USHC",
            "identifier": "0007210291",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD GROUP#",
            "identifier": "061557734",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET GROUP#",
            "identifier": "0V6399",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE GRP#",
            "identifier": "615577",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001396771",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS NBG GRP#",
            "identifier": "500HBL433CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NBG GRP#",
            "identifier": "004199057P1",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS BMH GRP#",
            "identifier": "500HBL433CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9094684",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE BMH GRP#",
            "identifier": "004199057P2",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE GRP#",
            "identifier": "1104295",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.