Active NPI
Elvira Vasilchenko
- Acupuncturist
- San Diego, CA
National Provider Identifier
1124632476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- CA18586
- Practice address
- 10951 Sorrento Valley Rd Ste 1D
San Diego, CA 92121-1613 - Phone
- (619) 598-5488
- NPI assigned
- Sep 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 78334 | CA | |
| Acupuncturist | 171100000X | CA18586 | CA | Primary |
Addresses
Primary practice location
10951 Sorrento Valley Rd Ste 1D
San Diego, CA 92121-1613
Mailing address
161 Palm Ave
Imperial Beach, CA 91932-1048
Phone (619) 354-0455
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18586 | Medicaid | CA | |
| CA18586 | Other | CA | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | SOAP | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 78334 | CA | MD | Marriage & Family Therapist |
| CA18586 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599091200000",
"number": "1124632476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 PALM AVE",
"city": "IMPERIAL BEACH",
"state": "CA",
"postal_code": "919321048",
"telephone_number": "619-354-0455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10951 SORRENTO VALLEY RD STE 1D",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211613",
"telephone_number": "619-598-5488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VASILCHENKO",
"first_name": "ELVIRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-03",
"last_updated": "2020-09-03",
"certification_date": "2020-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "CA",
"license": "78334",
"primary": false
},
{
"code": "171100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Acupuncturist",
"state": "CA",
"license": "CA18586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "18586",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CA18586",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "SOAP",
"affiliation": "N",
"endpointDescription": "sOAP notes",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "SOAP notes",
"address_1": "10951 Sorrento Valley Rd Ste 1D",
"city": "San Diego",
"state": "CA",
"country_code": "US",
"postal_code": "921211613",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.