Ivanka a. Vassileva, M.D., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22970 Issued in OK

Legal business name

IVANKA A. VASSILEVA, M.D., P.C.

Practice address

4411 W Gore Blvd
Suite B-10
Lawton, OK 73505-5977

Phone

(580) 354-9600

Fax

(580) 354-9621

NPI assigned

Oct 10, 2007

Last updated

Feb 9, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ivanka A. Vassileva, M.D.NPI 1295729929

Title

Owner

Phone

(580) 354-9600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Comanche County Hospital Authority

  dba Comanche County Memorial Hospital

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1720022379

  O20050804000956

  Same enrollment
• Southwestern Medical Center, LLC

  dba Southwestern Medical Center

  • General Acute Care Hospital
  • Lawton, OK
  • NPI 1952359986

  O20050804000956

  Same enrollment

Practitioners 1

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.

• Ivanka A Vassileva, MD

  • Family Medicine Physician
  • Lawton, OK
  • NPI 1295729929
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1245428630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD",
            "address_2": "SUITE B-10",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055977",
            "telephone_number": "580-354-9600",
            "fax_number": "580-354-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 W GORE BLVD",
            "address_2": "SUITE B-10",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055977",
            "telephone_number": "580-354-9600",
            "fax_number": "580-354-9621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVANKA A. VASSILEVA, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "VASSILEVA",
        "authorized_official_first_name": "IVANKA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-354-9600",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "22970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle Zlatnik, Aprn-CNP, PLLC
• Arlene L Isham, RN
• Sherif S Ismail, MD
• Ithrive Counseling Services, LLC (Cynthia M. Osuna)
• Eugen Ivan, MD
• James Iverson III
• Ruthanna B Ives
• Mary Elvina Ivey-Sleight, RN
• Serratu Omosomi Iyamah
• J Dean Nolan OD Inc

• Family Medicine Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.