NPIMap

Individual provider Active NPI

Alexander Anatolevich Ivanov, MD

  • Clinical Cardiac Electrophysiology Physician
  • Gastonia, NC
National Provider Identifier
1356873657
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
262249 Issued in NC
Practice address
2555 Court Dr Ste 200
Gastonia, NC 28054-2178
Phone
(704) 834-3278
NPI assigned
Mar 28, 2017
Last updated
May 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 262249 NC
Clinical Cardiac Electrophysiology Physician 207RC0001X 262249 NC Primary

Addresses

Primary practice location

2555 Court Dr Ste 200
Gastonia, NC 28054-2178

Mailing address

2555 Court Dr Ste 200
Gastonia, NC 28054-2178
Phone (704) 834-3278

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WI2 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
I20200930000890 NC Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 5698194314 Reassigns benefits to 3 organizations
I20240719001074 WI Practitioner - Cardiovascular Disease (Cardiology) 5698194314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1836 S Ave
La Crosse, WI 54601-5429
Phone (608) 783-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
262249NCMDClinical Cardiac Electrophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jul 1, 2022 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Internal Medicine CurrentSince Jul 30, 2023 Accepting new patients
Gundersen Lutheran Express Care, Inc CurrentSince Jul 3, 2024 Accepting new patients
Gundersen Lutheran Medical Center Inc CurrentSince Jul 3, 2024 Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Unc Rockingham Health Care, Inc. CurrentSince Oct 1, 2020 Accepting new patients
Unc Rockingham Health Care, Inc. Current Accepting new patients
Gundersen Clinic, LTD. CurrentSince Jul 3, 2024 Accepting new patients
Unc Rockingham Health Care, Inc. Current Accepting new patients
Morehead Memorial Hospital Current Accepting new patients
Gundersen Clinic LTD Current Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 30, 2023 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jul 3, 2024 Accepting new patients

Locations

117 E Kings Hwy
Eden, NC 27288
Phone (336) 627-6181

1126 N Church St
Ste 300
Greensboro, NC 27401
Phone (336) 547-1700

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

509 N Elam Ave
Fl 3
Greensboro, NC 27403
Phone (336) 832-1970

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681

610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466

505 Gopher Dr
Tomah, WI 54660
Phone (608) 372-2181

Interoperability endpoints

  • Direct secure messaging: aivanov832125@direct.novanthealth.org
  • Direct secure messaging: aivanov870797@direct.emplifyhealth.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1356873657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542178",
            "telephone_number": "704-834-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542178",
            "telephone_number": "704-834-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "ALEXANDER",
        "middle_name": "ANATOLEVICH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "262249",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "262249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.