Oleg V Desyatnikov, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

OS20593 Issued in FL

Practice address

1011 E Cumberland Ave Unit 2007
Tampa, FL 33602-4275

Phone

(941) 587-1013

NPI assigned

Mar 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, FL2 enrollments

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 2

Specialty

Anesthesiology

Education

Lake Erie College of Osteopathic Medicine, Bradenton, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gulf-to-Bay Anesthesiology Associates LLCGroup PAC ID 5092628156, 330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tampa General Hospital Hospital, Tampa, FL, CCN 100128

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: odesyatnikov2934407@carolinashealthcaresystem.direct-ci.com

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.

• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1720039746
  Medicare reassignment Care Compare group NPD
• Ams National LLC

  • Anesthesiology Physician
  • Pensacola, FL
  • NPI 1316330830
  Medicare reassignment NPD
• Anesthesiology Professional Services, Inc.

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1902856891
  Medicare reassignment NPD
• James G Hankerson PA

  dba Magnolia Anesthesia Consultants

  • Anesthesiology Physician
  • Tampa, FL
  • NPI 1235332354
  Medicare reassignment NPD
• Carolina Anesthesiology, PA

  • Anesthesiology Physician
  • High Point, NC
  • NPI 1629032347
  Medicare reassignment NPD
• Gulf-to-Bay Anesthesiology Associates LLC

  • Anesthesiology Physician
  • Largo, FL
  • NPI 1316205339
  NPD
• Gulf-to-Bay Anesthesiology Associates LLC

  • Pain Medicine (Anesthesiology) Physician
  • Riverview, FL
  • NPI 1497082655
  NPD

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

• Florida Health Sciences Center Inc

  dba Tampa General Hospital

  • General Acute Care Hospital
  • Tampa, FL
  • NPI 1235196510
  Care Compare affiliation

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1134757164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 E CUMBERLAND AVE UNIT 2007",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 E CUMBERLAND AVE UNIT 2007",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024275",
            "telephone_number": "941-587-1013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11750 Bird Rd",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331753530",
            "country_code": "US",
            "telephone_number": "305-222-5202",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 Ferndale Blvd",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272624739",
            "country_code": "US",
            "telephone_number": "336-882-2567",
            "fax_number": "336-882-5466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESYATNIKOV",
        "first_name": "OLEG",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2024-01888",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "OS20593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michelle Deterding, CRNA
• Cristina Lyn Dethloff, RD, LD/N
• Jerica Detsch, COTA/L
• Jennifer Lynn Dettloff, M.D.

• Anesthesiology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.

Verify at the official NPI Registry.