NPIMap

Individual provider Active NPI

Mladen Vladimirov Grigorov, DO

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1336609403
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS19898 Issued in FL
Practice address
530 S Jackson St
Louisville, KY 40202-1675
Phone
(502) 852-5555
NPI assigned
Mar 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 05220 KY
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X OS19898 FL Primary

Addresses

Primary practice location

530 S Jackson St
Louisville, KY 40202-1675

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 852-5666

Other identifiers 1

IdentifierTypeStateIssuer
7100682680MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220627002741 KY Practitioner - Internal Medicine 9739505561 Reassigns benefits to 2 organizations
I20230714000660 FL Practitioner - Internal Medicine 9739505561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Physician Group IncGroup PAC ID 2365679057, 953 clinicians
University of Louisville Physicians IncGroup PAC ID 3476725599, 1,438 clinicians

Practice addresses (Care Compare)

13901 Bruce B Downs Blvd
Tampa, FL 33613-3905
Phone (813) 615-7260

2600 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9207
Phone (813) 929-5436

2700 Healing Way
Wesley Chapel, FL 33543-5453

3100 E Fletcher Ave
Tampa, FL 33613-4613
Phone (813) 615-7075

530 S Jackson St
Louisville, KY 40202-1675
Phone (502) 562-3000

Hospital & facility affiliations

  • Adventhealth Wesley Chapel Hospital, Wesley Chapel, FL, CCN 100319
  • Adventhealth Tampa Hospital, Tampa, FL, CCN 100173
  • Adventhealth North Pinellas Hospital, Tarpon Springs, FL, CCN 100055
  • AdventHealth Carrollwood Hospital, Tampa, FL, CCN 100069

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS19898FLMDInternal Medicine Physician

Practice roles (8 of 10)

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jun 13, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 8, 2022 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine CurrentSince Jun 13, 2022 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Aug 2, 2023 Accepting new patients
Adventist Health System-Sunbelt Inc Internal Medicine CurrentSince Aug 2, 2023 Accepting new patients
University of Louisville Physicians, Inc. Internal Medicine Current Accepting new patients
Florida Hospital Physician Group Inc Internal Medicine CurrentSince Aug 2, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 8, 2022 Accepting new patients

Locations

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

13901 Bruce B Downs Blvd
Tampa, FL 33613
Phone (813) 615-7260

13067 N Telecom Pkwy
Temple Terrace, FL 33637
Phone (813) 333-9108

2700 Healing Way
Ste 310
Wesley Chapel, FL 33543
Phone (813) 779-1209

7752 Solution Ctr
Chicago, IL 60677

1025 New Moody Ln
Lagrange, KY 40031
Phone (502) 222-3335

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1553299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1336609403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-852-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 S JACKSON ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021675",
            "telephone_number": "502-852-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGOROV",
        "first_name": "MLADEN",
        "middle_name": "VLADIMIROV",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-23",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05220",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS19898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100682680",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.