George Michael Dmytrenko, M.D., PH.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME0062184 Issued in FL

Practice address

5153 N 9TH Ave
Pensacola, FL 32504-8785

Phone

(850) 416-2554

Fax

(850) 416-2536

NPI assigned

Aug 1, 2006

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 FL

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, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: george.dmytrenko.1@9582.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.

• Sacred Heart Health System, Inc.

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308
  Medicare reassignment NPD
• Sacred Heart Health System Inc

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1366260739
  NPD
• Sacred Heart Health System, Inc.

  • Family Medicine Physician
  • Pensacola, FL
  • NPI 1144271586
  NPD
• Sacred Heart Health System, Inc.

  • Neurological Surgery Physician
  • Pensacola, FL
  • NPI 1902857352
  NPD (past)
• The Neurosurgical Group Sisco & Tippett Chapleau & Frank

  • Neurological Surgery Physician
  • Pensacola, FL
  • NPI 1073528477
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1104833557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5153 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048785",
            "telephone_number": "850-416-2554",
            "fax_number": "850-416-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DMYTRENKO",
        "first_name": "GEORGE",
        "middle_name": "MICHAEL",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0062184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371074200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Djuric Chiropractic
• Slavoljub Djuric, DDS
• Vladimir Djuric, DC
• DLC Delta, Inc.
• Dmddds, Inc.
• DN Courier Services 'LLC'
• Dna Comprehensive Therapy Services, LLC
• Dne Direct Care Services LLC
• Kim DO, D.D.S.
• Andrew P Doan, M.D., PH.D.

• Neurology Physician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.