Individual provider Active NPI

Mariya Vengrenyuk, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1013367309
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
84258 Issued in TX
Practice address
7600 Central Ave FL 2
Philadelphia, PA 19111-2442
Phone
(215) 728-2276
Fax
(215) 214-4119
NPI assigned
Jun 16, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 84258 TX Primary
Internal Medicine Physician 207R00000X MD468755 PA
Internal Medicine Physician 207R00000X 302324 NY
Internal Medicine Physician 207R00000X MT212010 PA

Addresses

Primary practice location

7600 Central Ave FL 2
Philadelphia, PA 19111-2442

Mailing address

245 N 15TH St FL 6
Philadelphia, PA 19102-1101
Phone (215) 762-7000

Other practice location 1

245 N 15th St Fl 6
Philadelphia, PA 19102-1101
Phone (215) 762-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, DE, PA, NY, GA, FL6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20190709002516 WI Practitioner - HospitalistPractitioner - Internal Medicine 9638426372 Reassigns benefits to 2 organizations
I20191111002449 DE Practitioner - HospitalistPractitioner - Internal Medicine 9638426372 Reassigns benefits to 1 organization
I20200123001945 PA Practitioner - HospitalistPractitioner - Internal Medicine 9638426372 Reassigns benefits to 4 organizations
I20200124001398 NY Practitioner - HospitalistPractitioner - Internal Medicine 9638426372 Reassigns benefits to 3 organizations
I20200211002898 GA Practitioner - HospitalistPractitioner - Internal Medicine 9638426372 Reassigns benefits to 1 organization
I20211123002986 FL Practitioner - Internal MedicinePractitioner - Hospitalist 9638426372 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Apogee Medical Group GeorgiaGroup PAC ID 4587676945, 122 clinicians
Apogee Medical Group Delaware IncGroup PAC ID 9638312572, 94 clinicians

Practice addresses (Care Compare)

2501 N Patterson St
Valdosta, GA 31602-1735
Phone (229) 333-1000

640 S State St
Dover, DE 19901-3530
Phone (302) 674-4700

801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611

Hospital & facility affiliations

  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84258TXMDProfessional Counselor
302324NYMDInternal Medicine Physician
MT212010PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Dec 1, 2019 Accepting new patients
Temple Physicians Inc Internal Medicine Current Accepting new patients
Apogee Medical Group, Florida Inc CurrentSince Nov 1, 2021 Accepting new patients
Temple Physicians Inc. CurrentSince Apr 8, 2020 Accepting new patients
24 On Physicians, PC CurrentSince May 12, 2020 Accepting new patients
Apogee Medical Group, Wisconsin, S.C Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Apogee Medical Group, Delaware, Inc Internal Medicine CurrentSince Oct 7, 2019 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
North Shore - Lij Medical PC Internal Medicine CurrentSince Jul 1, 2020 Accepting new patients
Inpatient Specialists Group Internal Medicine CurrentSince Jun 17, 2022 Accepting new patients
Apogee Medical Group Georgia Internal Medicine CurrentSince Dec 15, 2019 Accepting new patients
Apogee Medical Group Waukesha, SC CurrentSince Jul 1, 2019 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jan 1, 2021 Accepting new patients
Reddy & Associates PC CurrentSince May 3, 2020 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Dec 1, 2019 Accepting new patients
24 On Physicians, P.C. CurrentSince May 12, 2020 Accepting new patients
Temple Faculty Practice Plan Inc Current Accepting new patients
Hospitalist Medicine Physicians of Pennsylvania, P.C. Internal Medicine CurrentSince Jan 26, 2021 Accepting new patients
Temple Physician Inc. Internal Medicine CurrentSince Apr 8, 2020 Accepting new patients
Apogee Medical Group, New York, PC Internal Medicine CurrentSince Dec 15, 2019 Accepting new patients
Inpatient Specialists Group Internal Medicine CurrentSince Jun 17, 2022 Accepting new patients
Temple Faculty Practice Plan Inc CurrentSince Jan 1, 2021 Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients
Temple Physicians Inc Past Accepting new patients
Temple Physicians Inc Internal Medicine PastSince May 3, 2020 Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

640 S State St
Dover, DE 19901
Phone (302) 744-4700

203 N Marion St
Fl 2
Tampa, FL 33602
Phone (813) 428-6904

203 N Marion St
Tampa, FL 33602
Phone (813) 474-9804

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

705 Dixie St
Carrollton, GA 30117
Phone (770) 812-9666

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

601 Dallas Hwy
Villa Rica, GA 30180
Phone (770) 456-3000

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

327 Beach 19th St
Far Rockaway, NY 11691
Phone (718) 689-7640

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

515 Main St
Olean, NY 14760
Phone (716) 373-2600

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

515 Pennsylvania Ave
Fl 2
Ft Washington, PA 19034
Phone (215) 540-0120

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

100 E Lehigh Ave
Philadelphia, PA 19125
Phone (215) 707-1200

3401 N Broad St
Philadelphia, PA 19140
Phone (215) 707-3807

7600 Central Ave
Fl 2
Philadelphia, PA 19111
Phone (215) 725-7600

7600 Central Ave
Philadelphia, PA 19111
Phone (215) 707-5522

559 W Germantown Pike
West Norriton, PA 19403
Phone (484) 622-1000

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210

725 American Ave
Waukesha, WI 53188
Phone (262) 544-2011

Networks

  • Freedom Health HMO Network

Organizations & group practices 25

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.

View all 25

Hospital & facility affiliations 3

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1013367309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N 15TH ST FL 6",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021101",
            "telephone_number": "215-762-7000",
            "fax_number": "215-762-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 CENTRAL AVE FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112442",
            "telephone_number": "215-728-2276",
            "fax_number": "215-214-4119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 N 15th St Fl 6",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191021101",
            "country_code": "US",
            "telephone_number": "215-762-7000",
            "fax_number": "215-762-7765",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENGRENYUK",
        "first_name": "MARIYA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "84258",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD468755",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "302324",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT212010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.