Active NPI
Ilya Vishevsky, RDMS
- Sonography Radiologic Technologist
- Bellevue, WA
National Provider Identifier
1063407179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sonography Radiologic Technologist
- Practice address
- 1611 116TH Ave NE Ste 207
Bellevue, WA 98004-3063 - Phone
- (425) 235-5984
- Fax
- (425) 226-6331
- NPI assigned
- Sep 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sonography Radiologic Technologist | 2471S1302X | WA | Primary |
Addresses
Primary practice location
1611 116TH Ave NE Ste 207
Bellevue, WA 98004-3063
Mailing address
PO Box 33879
Seattle, WA 98133-0879
Phone (425) 235-5984
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7072663 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 601470187 | WA | MD | Sonography Radiologic Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diagnostic Services, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mobile Radiology Clinic/Center
- Bellevue, WA
- NPI 1609863372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204588800000",
"number": "1063407179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33879",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981330879",
"telephone_number": "425-235-5984",
"fax_number": "425-226-6331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 116TH AVE NE STE 207",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980043063",
"telephone_number": "425-235-5984",
"fax_number": "425-226-6331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VISHEVSKY",
"first_name": "ILYA",
"name_prefix": "Mr.",
"credential": "RDMS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-14",
"last_updated": "2008-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "2471S1302X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Sonography",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7072663",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.