NPIMap

Individual provider Active NPI

Mikhail Mavashev, MD

  • Family Medicine Physician
  • Saratoga Springs, NY
National Provider Identifier
1275721797
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
245877 Issued in NY
Practice address
211 Church St
Saratoga Springs, NY 12866-1032
Phone
(518) 587-1141
Fax
(518) 587-1152
NPI assigned
Oct 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 245877 NY Primary

Addresses

Primary practice location

211 Church St
Saratoga Springs, NY 12866-1032

Mailing address

454 Maple Ave
Saratoga Springs, NY 12866-5532
Phone (518) 587-1141

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080122000372 NY Practitioner - Family Practice 6305927906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

211 Church St
Saratoga Springs, NY 12866-1003
Phone (518) 583-8497

Hospital & facility affiliations

  • Saratoga Hospital Hospital, Saratoga Springs, NY, CCN 330222

Merit-based Incentive Payment System (MIPS)

Final score
68.51 of 100Reported as group
Quality
56.19
Improvement activities
40
Cost
75.36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital Family Medicine CurrentSince Nov 11, 2017 Accepting new patients
Saratoga Hospital Current Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

112 Charlton Rd
Charlton, NY 12019
Phone (518) 399-7723

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

3044 Route 50
Saratoga Springs, NY 12866
Phone (518) 886-5800

Interoperability endpoints

  • Direct secure messaging: mmavashev100089@albanymed.direct-ci.com

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1275721797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 MAPLE AVE",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128665532",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CHURCH ST",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128661032",
            "telephone_number": "518-587-1141",
            "fax_number": "518-587-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVASHEV",
        "first_name": "MIKHAIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "245877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.