NPIMap

Individual provider Active NPI

Adrian Michael Danchenko, MD

  • Cardiovascular Disease Physician
  • Cookeville, TN
National Provider Identifier
1124027230
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
53777 Issued in TN
Practice address
228 W 4TH St Ste 200
Cookeville, TN 38501-2489
Phone
(931) 372-0405
Fax
(931) 372-0463
NPI assigned
Jul 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 53777 TN Primary

Addresses

Primary practice location

228 W 4TH St Ste 200
Cookeville, TN 38501-2489

Mailing address

140 W 7TH St
Cookeville, TN 38501-1726
Phone (931) 372-0405

Other identifiers 2

IdentifierTypeStateIssuer
Q036399MedicaidTN
53777OtherTNMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031222000217 FL Practitioner - Cardiovascular Disease (Cardiology) 1951209519 Reassigns benefits to 1 organization
I20181017003718 TN Practitioner - Cardiovascular Disease (Cardiology) 1951209519 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Uniformed Services Uhs Fe Hebert School of Med, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CRMC Mso Sub 1 IncorporatedGroup PAC ID 1052332830, 21 clinicians
Stern Cardiovascular Center, PAGroup PAC ID 2860390275, 126 clinicians

Practice addresses (Care Compare)

228 W 4TH St
Suite 200
Cookeville, TN 38501-2489
Phone (931) 372-0405

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
56.05 of 100Reported as individual
Quality
58.18
Promoting interoperability
0
Improvement activities
40
Cost
71.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
CRMC Mso Sub 1, Incorporated CurrentSince Oct 1, 2023 Accepting new patients
Tenet Florida Physician Services, LLC CurrentSince Feb 3, 2014 Accepting new patients
Tenet Florida Physician Services LLC Cardiovascular Disease CurrentSince Feb 3, 2014 Accepting new patients
Clarksville Physician Services, LLC Past Accepting new patients
Stuart Cardiology Group LLC Cardiovascular Disease PastSince Aug 1, 2023 Accepting new patients

Locations

200 SE Hospital Ave
Stuart, FL 34994
Phone (772) 223-5618

509 SE Riverside Dr
Stuart, FL 34994
Phone (772) 223-2300

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

228 W 4th St
Ste 200
Cookeville, TN 38501
Phone (931) 372-0405

140 W 7th St
Cookeville, TN 38501
Phone (931) 783-5582

Interoperability endpoints

  • Direct secure messaging: mwf1723@yourcarecommunity.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1124027230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 W 7TH ST",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385011726",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 W 4TH ST STE 200",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012489",
            "telephone_number": "931-372-0405",
            "fax_number": "931-372-0463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANCHENKO",
        "first_name": "ADRIAN",
        "middle_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "53777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q036399",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "53777",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.