Dmitry Novoseletsky, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

01062695A Issued in IN

Practice address

1110 W Schick Rd
Bartlett, IL 60103-3007

Phone

(630) 233-7029

Fax

(630) 372-0852

NPI assigned

Jul 20, 2006

Last updated

Jan 25, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Pain & Anesthesia Consultants, PC

  dba Apac, PC

  • Pain Medicine (Anesthesiology) Physician
  • Crown Point, IN
  • NPI 1457387078

  IL, Physical Medicine & Rehabilitation

  Medicare reassignment NPD
• Strong Spine Institute, PLLC

  • Physical Medicine & Rehabilitation Physician
  • Highland Park, IL
  • NPI 1902479132
  NPD Authorized official
• Advance Pain & Anesthesia Consultants, PC

  • Durable Medical Equipment & Medical Supplies
  • La Porte, IN
  • NPI 1629966106
  NPD
• Spine Technology and Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Angola, IN
  • NPI 1154304186
  NPD (past)
• Spine Technology and Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Fort Wayne, IN
  • NPI 1245213263
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359072000000",
    "number": "1043230345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W SCHICK RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601033007",
            "telephone_number": "630-233-7029",
            "fax_number": "630-483-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W SCHICK RD",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601033007",
            "telephone_number": "630-233-7029",
            "fax_number": "630-372-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOSELETSKY",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2013-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01062695A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200858900",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon NG
• Elizabeth J Nicholson
• Kristen Nickol, LCSW
• Susan Ninos
• Northwestern Medivan Inc
• Lauren Nowak
• Jennifer Kay Nowakowski, DEVELOPMENTAL THERAP
• Nicole C Nugent, MOT, OTR/L
• Lalin Nuth, D.O.
• Daniel O'Malley, DO

• Physical Medicine & Rehabilitation Physician in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.