NPIMap

Individual provider Active NPI

Nikolai Kinachtchouk, M.D.

  • Internal Medicine Physician
  • Saginaw, MI
National Provider Identifier
1306830963
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
NK065669 Issued in MI
Practice address
4705 Towne Ctr
Suite 102
Saginaw, MI 48604-2818
Phone
(989) 790-2984
Fax
(989) 790-2983
NPI assigned
Sep 9, 2005
Last updated
Sep 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NK065669 MI Primary

Addresses

Primary practice location

4705 Towne Ctr
Suite 102
Saginaw, MI 48604-2818

Mailing address

4705 Towne Ctr
Suite 102
Saginaw, MI 48604-2818
Phone (989) 790-2984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040205000733 MI Practitioner - Internal Medicine 5991698631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Saginaw Valley Medical College - NLG, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4705 Towne Centre Rd
Suite 102
Saginaw, MI 48604-2820
Phone (989) 497-3144

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions38
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NK065669MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Nikolai Kinachtchouk,M.D. & Lioudmila Kinachtchouk,M.D. P.L.C. Internal Medicine CurrentSince May 23, 2008 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

4705 Towne Centre Rd
Ste 102
Saginaw, MI 48604
Phone (517) 797-3145

Interoperability endpoints

  • Direct secure messaging: nikolai.kinachtchouk.1@29770.direct.athenahealth.com
  • Direct secure messaging: nikolaikinachtchouk-mmnlk@direct.medalliesmail.com

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222646400000",
    "number": "1306830963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CTR",
            "address_2": "SUITE 102",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042818",
            "telephone_number": "989-790-2984",
            "fax_number": "989-790-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 TOWNE CTR",
            "address_2": "SUITE 102",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486042818",
            "telephone_number": "989-790-2984",
            "fax_number": "989-790-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINACHTCHOUK",
        "first_name": "NIKOLAI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2008-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "NK065669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

Verify at the official NPI Registry.