Michael Chervonski, M.D.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

A172276 Issued in CA

Practice address

1010 Murray Ave
San Luis Obispo, CA 93405-1806

Phone

(805) 546-7600

NPI assigned

Apr 6, 2012

Last updated

Jan 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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 HI

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

Specialty

Diagnostic Radiology

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Queens North Hawaii Community HospitalGroup PAC ID 0143116293, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001
• North Hawaii Community Hospital, Inc Hospital, Kamuela, HI, CCN 120028
• Molokai General Hospital Hospital, Kaunakakai, HI, CCN 121303

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Queens North Hawaii Community Hospital

  • Orthopaedic Surgery Physician
  • Kamuela, HI
  • NPI 1528049814
  Medicare reassignment Care Compare group NPD
• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group NPD
• Pacific Radiology Group Inc

  • Specialist
  • Honolulu, HI
  • NPI 1871577536
  Medicare reassignment
• North Hawaii Community Hospital

  dba NHCH - Diabetes Wellness

  • General Acute Care Hospital
  • Kamuela, HI
  • NPI 1831380724
  NPD

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

• Molokai General Hospital

  • Critical Access Hospital
  • Kaunakakai, HI
  • NPI 1366486979
  Care Compare affiliation
• Queens North Hawaii Community Hospital

  • General Acute Care Hospital
  • Kamuela, HI
  • NPI 1477559029
  Care Compare affiliation
• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1336405018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 STONERIDGE DR",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015669",
            "telephone_number": "404-379-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MURRAY AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051806",
            "telephone_number": "805-546-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERVONSKI",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2022-01-07",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A172276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genie Cheng
• Jacob Cherdak
• Justin Robert Chernow, PH.D.
• Deborah A. Cherry, M.D.
• Ruth Cherry, PHD
• Chelsea Marin Chezem, LPT
• Kevin J Chiles
• Victoria Marie Chipres
• Guy N Chirman, M.D.
• Matthew Robert Chirman, LMFT

• Vascular & Interventional Radiology Physician in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.