Nadezhda Kravchuk, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

59965 Issued in ID

Practice address

1150 N Sister Catherine Way
Nampa, ID 83687

Phone

(208) 302-7000

Fax

(208) 302-7055

NPI assigned

Oct 29, 2018

Sex

Female

Sole proprietor

Yes

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 ID

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, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain Pine Dermatology PLLCGroup PAC ID 8729366455, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke's Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkravchuk@mtnpinederm.emadirect.md

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.

• Mountain Pine Dermatology, PLLC

  • Dermatology Physician
  • Meridian, ID
  • NPI 1659827665
  Medicare reassignment Care Compare group NPD
• West Valley Medical Group LLC

  • Internal Medicine Physician
  • Caldwell, ID
  • NPI 1871673798
  Medicare reassignment NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)
• West Valley Medical Group Specialty Services LLC

  • Obesity Medicine (Obstetrics & Gynecology) Physician
  • Caldwell, ID
  • NPI 1245659093
  NPD (past)

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

• St Lukes West LTD

  dba St Lukes Nampa Medical Center

  • General Acute Care Hospital
  • Nampa, ID
  • NPI 1831590660
  Care Compare affiliation

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1033686076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR.",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-7000",
            "fax_number": "208-302-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N SISTER CATHERINE WAY",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "83687",
            "telephone_number": "208-302-7000",
            "fax_number": "208-302-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAVCHUK",
        "first_name": "NADEZHDA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "59965",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "59965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Koster, LMSW
• Cassidy O Kotte
• Breonna V Krafft-Harris, LPC
• Catherine D Kraus, LCSW
• Evgenia Kravchuk
• Stanislav Kravchuk
• Phillip Wade Kreissler, DPT
• Joseph D Kronz, M.D.
• Kari Krueger
• Dianne Kay Kruse, LCPC MA, EED, EDS

• Nurse Practitioner in Nampa, ID
• Providers in Nampa, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; 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.