Active NPI
Ivan Shvachuk, MD
- Family Medicine Physician
- Schenectady, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 240695
- Practice address
- 1101 Nott St
Schenectady, NY 12308-2425 - Phone
- (518) 243-4000
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 240695 | NY | Primary |
| Internal Medicine Physician | 207R00000X | 240695 | NY |
Addresses
Primary practice location
1101 Nott St
Schenectady, NY 12308-2425
Mailing address
1462 Erie Blvd
Suite 2
Schenectady, NY 12305-1026
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10115093 | Other | NY | CDPHP |
| 000411953001 | Other | NY | BSNENY |
| 11568824 | Other | CAQH | |
| 4149461 | Other | NY | MVP |
| 070209000089 | Other | NY | FIDELIS CARE |
| 240SD1 | Other | NY | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1101 Nott St
Schenecctady, NY 12308-2425
Phone (518) 243-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 240695 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellis Hospital | Current | Accepting new patients |
Locations
600 McClellan St
Schenectady, NY 12304
Phone (518) 382-2000
1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916
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.
-
- General Acute Care Hospital
- Schenectady, NY
- NPI 1487644993
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Schenectady, NY
- NPI 1487644993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1154346393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1462 ERIE BLVD",
"address_2": "SUITE 2",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123051026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 NOTT ST",
"city": "SCHENECTADY",
"state": "NY",
"postal_code": "123082425",
"telephone_number": "518-243-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHVACHUK",
"first_name": "IVAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "240695",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "240695",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDPHP",
"identifier": "10115093",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSNENY",
"identifier": "000411953001",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11568824",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP",
"identifier": "4149461",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS CARE",
"identifier": "070209000089",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "240SD1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Schenectady, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.