Ivaylo Veselinov

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95028573 Issued in CA

Practice address

199 E Webster St
Colusa, CA 95932-0019

Phone

(530) 619-0800

NPI assigned

May 20, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ivaylo Iliyanov Veselinov Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ivaylo.veselinov.1@19854.direct.athenahealth.com

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.

• American Specialty Physicians Group Inc

  • Emergency Medicine Physician
  • Modesto, CA
  • NPI 1568992923
  Medicare reassignment NPD

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1093554172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 N RIVINGTON WAY",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167484",
            "telephone_number": "208-717-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 E WEBSTER ST",
            "city": "COLUSA",
            "state": "CA",
            "postal_code": "959320019",
            "telephone_number": "530-619-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESELINOV",
        "first_name": "IVAYLO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95028573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVAYLO",
            "last_name": "VESELINOV",
            "middle_name": "ILIYANOV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Debra J. Tripp, MFT
• Joel Cristobal Varela, MASTER SOCIAL WORK
• Wendy D. Vazquez, MSW
• Gemma Mireya Velazquez, BA
• Eva Louise Vereschagin, MFTI
• Maribel Villasenor
• Vinay Panchal MD Inc
• Helen Vrazel
• Michael Joseph Wasilchin
• Western Physical Therapy, Inc.

• Family Medicine Physician in Colusa, CA
• Providers in Colusa, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.