Individual provider Active NPI

Vladimir Gurevich, L.S.A.

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1306998000
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA00040 Issued in TX
Practice address
2106 Woodland Springs St.
Houston, TX 77077-6307
Phone
(713) 826-1229
Fax
(281) 496-3112
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X SA00040 TX Primary

Addresses

Primary practice location

2106 Woodland Springs St.
Houston, TX 77077-6307

Mailing address

2106 Woodland Springs St
Houston, TX 77077-6307
Phone (713) 826-1229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA00040TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vgsa, Inc Single Specialty Past Accepting new patients

Organizations & group practices 1

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1306998000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 WOODLAND SPRINGS ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770776307",
            "telephone_number": "713-826-1229",
            "fax_number": "281-496-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 WOODLAND SPRINGS ST.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770776307",
            "telephone_number": "713-826-1229",
            "fax_number": "281-496-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUREVICH",
        "first_name": "VLADIMIR",
        "credential": "L.S.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.