Active NPI
Irina Goncharova, MD
- Vascular Surgery Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 49279
- Practice address
- 2801 W Kinnickinnic River Pkwy
Suite 485
Milwaukee, WI 53215-3669 - Phone
- (414) 646-8900
- NPI assigned
- Jul 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 49279 | WI | Primary |
| Surgery Physician | 208600000X | 03611663 | IL |
Addresses
Primary practice location
2801 W Kinnickinnic River Pkwy
Suite 485
Milwaukee, WI 53215-3669
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000
Other practice location 2
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 3
1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000
Other practice location 4
1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000
Other practice location 5
875 S Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
Other practice location 6
N2950 State Road 67
Lake Geneva, WI 53147-2655
Phone (262) 245-0535
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34885400 | Medicaid | WI | |
| 036.111663 | Other | IL | ILL LIC |
| 49279-20 | Other | WI | WI LIC |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | igoncharova119691@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Chicago, Pritzker School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000
Hospital & facility affiliations
- Javon Bea Hospital
- Mercy Health System Corp
- Saint Anthony Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03611663 | IL | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Mercy Health System Corporation | Current | Accepting new patients | |
| Rockford Health Physicians | Current | Accepting new patients |
Locations
29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652
875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500
1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105
348 S Division St
Harvard, IL 60033
Phone (815) 943-1122
8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066
2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510
2310 1st Center Ave
Brodhead, WI 53520
Phone (608) 897-8664
1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868
N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535
Interoperability endpoints
- igoncharova119691@direct.myadvocateaurora.org
- igoncharova1774@direct.mhemail.org
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Rockford, IL
- NPI 1043242886
-
- Critical Access Hospital
- Lake Geneva, WI
- NPI 1699728550
-
- General Acute Care Hospital
- Freeport, IL
- NPI 1447228788
-
- Family Medicine Physician
- Freeport, IL
- NPI 1457337016
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Janesville, WI
- NPI 1093768962
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1629118609
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1790739977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781740800000",
"number": "1104857465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 W KINNICKINNIC RIVER PKWY",
"address_2": "SUITE 485",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153669",
"telephone_number": "414-646-8900"
}
],
"practiceLocations": [
{
"address_1": "8201 E Riverside Blvd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "611142300",
"country_code": "US",
"telephone_number": "815-971-7000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1045 W Stephenson St",
"address_purpose": "LOCATION",
"city": "Freeport",
"state": "IL",
"postal_code": "610324864",
"country_code": "US",
"telephone_number": "815-599-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1000 Mineral Point Ave",
"address_purpose": "LOCATION",
"city": "Janesville",
"state": "WI",
"postal_code": "535482940",
"country_code": "US",
"telephone_number": "608-756-6000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "875 S Route 31",
"address_purpose": "LOCATION",
"city": "Crystal Lake",
"state": "IL",
"postal_code": "60014",
"country_code": "US",
"telephone_number": "779-220-5500",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "N2950 State Road 67",
"address_purpose": "LOCATION",
"city": "Lake Geneva",
"state": "WI",
"postal_code": "531472655",
"country_code": "US",
"telephone_number": "262-245-0535",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GONCHAROVA",
"first_name": "IRINA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2026-06-18",
"certification_date": "2026-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "WI",
"license": "49279",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "03611663",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34885400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ILL LIC",
"identifier": "036.111663",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WI LIC",
"identifier": "49279-20",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "igoncharova119691@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2801 W Kinnickinnic River Pkwy",
"address_2": "Suite 485",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153669",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2801 W Kinnickinnic River Pkwy",
"address_2": "Suite 485",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153669",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.