Vadim Selyukov

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

SP019675 Issued in PA

Practice address

8815 Germantown Ave Ste 16
Philadelphia, PA 19118-2722

Phone

(215) 242-1159

NPI assigned

Nov 29, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Abington Memorial HospitalGroup PAC ID 3274437736, 442 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174
• Jefferson Abington Hospital Hospital, Abington, PA, CCN 390231

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Abington Memorial Hospital

  • Hematology & Oncology Physician
  • Abington, PA
  • NPI 1730122789
  Medicare reassignment Care Compare group NPD
• Jefferson University Physicians

  • General Practice Physician
  • Philadelphia, PA
  • NPI 1326093675
  Medicare reassignment NPD
• Abington Memorial Hospital

  • Maternal & Fetal Medicine Physician
  • Abington, PA
  • NPI 1649033069
  NPD
• Womencare OB GYN, P.C.

  • Specialist
  • Willow Grove, PA
  • NPI 1881631166
  NPD (past)

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

• Abington Memorial Hospital

  • General Acute Care Hospital
  • Abington, PA
  • NPI 1811992084
  Care Compare affiliation
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1205306545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 LITTLE LN",
            "city": "WARMINSTER",
            "state": "PA",
            "postal_code": "189741963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8815 GERMANTOWN AVE STE 16",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191182722",
            "telephone_number": "215-242-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8815 Germantown Ave Ste 16",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191182722",
            "country_code": "US",
            "telephone_number": "215-242-1159",
            "fax_number": "215-242-4020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELYUKOV",
        "first_name": "VADIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-29",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP019675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janani Selvam
• Sruthi Selvam
• Santosh Kumar Selvarajan, M.D.
• Vithusha Selvavelautham, MA
• Kyra Selwyn, PSYD
• Michael E Selzer
• Harrison Joshua Selznick
• Amber Semanchyk, CRNP
• Brett Semar, DPT
• Edisio J Semeao, M.D.

• Primary Care Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Primary Care Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2019; 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.