Vitaliy Pavlovich Kovdiy

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP.AP.70132652-NP Issued in WA

Practice address

13201 E Manor Blvd
Burnsville, MN 55337-2093

Phone

(952) 649-2735

NPI assigned

Nov 26, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Washington Gastroenterology PLLC

  • Gastroenterology Physician
  • Tacoma, WA
  • NPI 1306364401
  Medicare reassignment

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

{
    "created_epoch": "1764115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1013879162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13201 E MANOR BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372093",
            "telephone_number": "952-649-2735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13201 E MANOR BLVD",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372093",
            "telephone_number": "952-649-2735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVDIY",
        "first_name": "VITALIY",
        "middle_name": "PAVLOVICH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-26",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "ARNP.AP.70132652-NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "13629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdullahi Ayanle Korane
• Ruweyda Korane
• Autumn Korby
• Lindsey Kororll
• Brandon Koupal, OD
• Emma Kraft, PA-S
• Gabrielle Kramer
• Olivia Jo Kramer
• Isabella Jayne Kranz
• Margaret Anne Kratz, BLS,ALS,CES

• Nurse Practitioner in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.