Individual provider Active NPI

Pavel Svintozelsky, MD

  • Student in an Organized Health Care Education/Training Program
  • Columbia, MO
National Provider Identifier
1144868019
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
2018038214 Issued in MO
Practice address
5083 Commercial Dr
Columbia, MO 65203-7291
Phone
(573) 814-1170
NPI assigned
Dec 11, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2018038214 MO Primary

Addresses

Primary practice location

5083 Commercial Dr
Columbia, MO 65203-7291

Mailing address

5083 Commercial Dr
Columbia, MO 65203-7291
Phone (573) 279-3819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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

Enrollment IDStateProvider typePAC IDDetails
I20241016001091 MO Practitioner - General Practice 3173055100 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Big Tree Medical Group LLC Family Medicine CurrentSince Aug 17, 2024 Accepting new patients

Locations

206 Corporate Lake Dr
Columbia, MO 65203
Phone (573) 814-1170

200 Corporate Lake Dr
Columbia, MO 65203
Phone (417) 234-2860

Interoperability endpoints

  • Direct secure messaging: pavel.svintozelsky@985026537848836.direct.elationemr.com
  • Direct secure messaging: pavel.svintozelsky@115443077021700.direct.elationemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745193600000",
    "number": "1144868019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5083 COMMERCIAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037291",
            "telephone_number": "573-279-3819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5083 COMMERCIAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652037291",
            "telephone_number": "573-814-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVINTOZELSKY",
        "first_name": "PAVEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2018038214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

Verify at the official NPI Registry.