Individual provider Active NPI

Felix Ermolenko, MD

  • Internal Medicine Physician
  • Pensacola, FL
National Provider Identifier
1194777029
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME85126 Issued in FL
Practice address
4451 Bayou Blvd
Pensacola, FL 32503-2601
Phone
(850) 416-2477
Fax
(850) 416-7520
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME85126 FL Primary

Addresses

Primary practice location

4451 Bayou Blvd
Pensacola, FL 32503-2601

Mailing address

PO Box 2699
Attn: SHMG/Hpe
Pensacola, FL 32513-2699
Phone (850) 416-7800

Other identifiers 2

IdentifierTypeStateIssuer
265034700MedicaidFL
P00756972OtherFLMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041208000238 FL Practitioner - Internal Medicine 8729044060 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

1657 Trinity Dr
Pensacola, FL 32504-5708
Phone (850) 416-0086

Hospital & facility affiliations

  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc Internal Medicine CurrentSince Jan 1, 2024 Accepting new patients
Sacred Heart Health System, Inc. CurrentSince Dec 1, 2004 Accepting new patients
Sacred Heart Health System, Inc. Internal Medicine Current Accepting new patients
Sacred Heart Health System Inc CurrentSince Jan 1, 2024 Accepting new patients
Sacred Heart Health System, Inc. Past Accepting new patients
Northwest Florida Primary Care LLC Past Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

615 N Bonita Ave
Panama City, FL 32401
Phone (850) 747-2020

5151 N 9th Ave
Pensacola, FL 32504
Phone (850) 202-4700

1657 Trinity Dr
Pensacola, FL 32504
Phone (850) 416-2400

4451 Bayou Blvd
Pensacola, FL 32503
Phone (850) 416-7619

5045 Carpenter Creek Dr
Pensacola, FL 32503
Phone (850) 416-2400

5153 N 9th Ave
Ste 302
Pensacola, FL 32504
Phone (850) 416-2250

Interoperability endpoints

  • Direct secure messaging: felix.ermolenko.1@9582.direct.athenahealth.com

Organizations & group practices 6

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.

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1194777029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "ATTN: SHMG/HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-416-7800",
            "fax_number": "850-416-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4451 BAYOU BLVD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032601",
            "telephone_number": "850-416-2477",
            "fax_number": "850-416-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMOLENKO",
        "first_name": "FELIX",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME85126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265034700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00756972",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.