NPIMap

Individual provider Active NPI

Evgueni Roudachevski, DO

  • Geriatric Medicine (Internal Medicine) Physician
  • Little Rock, AR
National Provider Identifier
1215993787
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
E2957 Issued in AR
Practice address
11912 Kanis Road
Suite F-2
Little Rock, AR 72211-3733
Phone
(501) 227-8020
Fax
(501) 227-8826
NPI assigned
Apr 25, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E2957 AR
Geriatric Medicine (Internal Medicine) Physician 207RG0300X E2957 AR Primary

Addresses

Primary practice location

11912 Kanis Road
Suite F-2
Little Rock, AR 72211-3733

Mailing address

11912 Kanis Road
Suite F-2
Little Rock, AR 72211-3733
Phone (501) 227-8020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040115000964 AR Practitioner - Geriatric MedicinePractitioner - Internal Medicine 0749181410 Receives reassigned benefits from 4 practitioners
Practice locations: Little Rock, AR

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1024 Scott St
Little Rock, AR 72202-3824
Phone (501) 227-8020

11912 Kanis Rd
Suite F2
Little Rock, AR 72211-3771
Phone (501) 227-8020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.82 of 100Reported as individual
Quality
83.33
Promoting interoperability
100
Improvement activities
40
Cost
61.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E2957ARMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evgueni Roudachevski, D.O. Geriatric Medicine PastSince Jan 1, 1990 Accepting new patients
Evgueni Roudachevski, D.O. PastSince Jan 1, 1990 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HBGICA/Endpoint/HBGICA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
The Blossoms at Conway Rehab & Nursing CenterConway, AR, CCN 045313 Skilled nursing facility Adp of the SNF Apr 5, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 2

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215993787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 KANIS ROAD",
            "address_2": "SUITE F-2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-227-8020",
            "fax_number": "501-227-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 KANIS ROAD",
            "address_2": "SUITE F-2",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722113733",
            "telephone_number": "501-227-8020",
            "fax_number": "501-227-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUDACHEVSKI",
        "first_name": "EVGUENI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E2957",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AR",
            "license": "E2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.