Individual provider Active NPI

Vitaly Piluiko, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Orange Park, FL
National Provider Identifier
1154398303
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
MD2019-0519 Issued in NM
Practice address
1893 Kingsley Ave
Ste a
Orange Park, FL 32073
Phone
(904) 592-4940
Fax
(904) 400-6673
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 109452 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X MD2019-0519 NM Primary

Addresses

Primary practice location

1893 Kingsley Ave
Ste a
Orange Park, FL 32073

Mailing address

2137 Sedona Hills Pkwy
Las Cruces, NM 88011-4135
Phone (786) 375-0622

Other identifiers 2

IdentifierTypeStateIssuer
004424700MedicaidFL
P01593698OtherFLMEDICARE RAILROAD

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address UNMH@direct.health.unm.edu
Direct Messaging Address UNMMG@direct.health.unm.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, MI, MT3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190821002854 NM Practitioner - Thoracic SurgeryPractitioner - General SurgeryPractitioner - Cardiac Surgery 9032182209 Reassigns benefits to 3 organizations
I20260318000751 MI Practitioner - Thoracic Surgery 9032182209 Reassigns benefits to 1 organization
I20260611000631 MT Practitioner - Thoracic Surgery 9032182209 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic SurgeryAlso: Cardiac Surgery, General Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4407 E Lohman Ave
Las Cruces, NM 88011-8267
Phone (575) 522-6806

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
109452FLMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Jan 7, 2023 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Dec 1, 2022 Accepting new patients
Las Cruces Physician Practices, LLC CurrentSince Dec 1, 2022 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients
Las Cruces Physician Practices, LLC Current Accepting new patients
Unm Medical Group, Inc. CurrentSince Jan 7, 2023 Accepting new patients
McLaren Macomb CurrentSince Feb 24, 2026 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jan 1, 2024 Accepting new patients
Familycare Associates,PA Past Accepting new patients
Susquehanna Physician Services Past Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients
Cardiac Surgery Associates SC Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

1000 Harrington St
Mount Clemens, MI 48043
Phone (586) 493-3727

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

4351 E Lohman Ave
Ste 403
Las Cruces, NM 88011
Phone (575) 522-6806

4351 E Lohman Ave
Ste 200
Las Cruces, NM 88011
Phone (505) 532-9755

4407 E Lohman Ave
Las Cruces, NM 88011
Phone (575) 522-6806

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Interoperability endpoints

  • Direct secure messaging: vitaly.piluiko.1@19849.direct.athenahealth.com
  • Direct secure messaging: vpiluiko781396@ahs.direct-ci.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1154398303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2137 SEDONA HILLS PKWY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114135",
            "telephone_number": "786-375-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1893 KINGSLEY AVE",
            "address_2": "STE A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-592-4940",
            "fax_number": "904-400-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PILUIKO",
        "first_name": "VITALY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "109452",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NM",
            "license": "MD2019-0519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004424700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P01593698",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMMG@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "800 Bradbury Dr SE Ste 116",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871064310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.