Individual provider Active NPI

Dmitry Ulend, NP

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1306344718
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP025446 Issued in PA
Practice address
14200 Bustleton Ave Ste 17
Philadelphia, PA 19116-1186
Phone
(267) 934-6769
Fax
(302) 735-3845
NPI assigned
Jan 31, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013108 NC
Nurse Practitioner 363L00000X LP-0000334 DE
Nurse Practitioner 363L00000X SP025446 PA Primary

Addresses

Primary practice location

14200 Bustleton Ave Ste 17
Philadelphia, PA 19116-1186

Mailing address

901 W Ashland Ave
Glenolden, PA 19036-1101
Phone (610) 461-6522

Other names 1

  • Dmytro Ulendyeyev Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180207002736 NM Practitioner - Nurse Practitioner 1557621729 Reassigns benefits to 1 organization
I20220816002768 PA Practitioner - Nurse Practitioner 1557621729 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LP-0000334DEMDNurse Practitioner
5013108NCMDNurse Practitioner
SP025446PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ulend Medical Practice LLC CurrentSince Apr 27, 2025 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2018 Accepting new patients
Oleg Volchonok, MD, PC CurrentSince Sep 3, 2022 Accepting new patients
Advanced Family Medicine PC CurrentSince Aug 17, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Mar 1, 2018 Accepting new patients
Northeast Medical and Rehabilitation Center, P.C. PastSince Aug 17, 2022 Accepting new patients

Locations

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

8300 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 291-2000

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

14200 Bustleton Ave
Ste 4
Philadelphia, PA 19116
Phone (215) 671-0900

14200 Bustleton Ave
Ste 17
Philadelphia, PA 19116
Phone (267) 934-6769

11400 Bustleton Ave
Philadelphia, PA 19116
Phone (215) 969-8446

Interoperability endpoints

  • Direct secure messaging: dulend79997@capefearvalley.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1306344718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W ASHLAND AVE",
            "city": "GLENOLDEN",
            "state": "PA",
            "postal_code": "190361101",
            "telephone_number": "610-461-6522",
            "fax_number": "610-461-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 BUSTLETON AVE STE 17",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191161186",
            "telephone_number": "267-934-6769",
            "fax_number": "302-735-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULEND",
        "first_name": "DMITRY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-31",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013108",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LP-0000334",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP025446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DMYTRO",
            "last_name": "ULENDYEYEV",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.