Pavel Veretilo, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

264613 Issued in NY

Practice address

3511 Shore Pkwy Apt A3
Brooklyn, NY 11235-2857

Phone

(646) 339-8380

NPI assigned

Mar 21, 2012

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: pveretilo1056798@nychhc.direct-ci.com

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.

• New York City Health and Hospitals Corporation

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1043224355
  NPD (past)

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1275808404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 SHORE PKWY APT A3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352857",
            "telephone_number": "646-339-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 SHORE PKWY APT A3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112352857",
            "telephone_number": "646-339-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERETILO",
        "first_name": "PAVEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "264613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph R Verdino, PH.D.
• Thomas Angelo Verdoni, DMD
• Verdun Home Care
• Daniella B Veres, LMSW
• Yulia Veretennikova
• Daryl Nacario Vergara
• Juan Vergara
• Zachary Vergara
• Marilyn Ann Verghese, O.D.
• Irene Josephine Vergilis-Kalner, M.D.

• Psychiatry Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.