Individual provider Active NPI

Aleksandr Pevtsov, DO

  • Emergency Medicine Physician
  • Lumberton, NC
National Provider Identifier
1376071001
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
04931 Issued in KY
Practice address
300 W 27TH St
Lumberton, NC 28358
Phone
(910) 735-8783
NPI assigned
May 25, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2018-01812 NC
Emergency Medicine Physician 207P00000X 81899 WI
Emergency Medicine Physician 207P00000X 04931 KY Primary

Addresses

Primary practice location

300 W 27TH St
Lumberton, NC 28358

Mailing address

PO Box 432
Pikeville, KY 41502-0432
Phone (606) 218-3500

Other practice location 1

911 Bypass Rd Bldg A
Pikeville, KY 41501-1689
Phone (606) 430-3500

Other practice location 2

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

Other practice location 3

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1041

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apevtsov21686@PIKEVILLEKYDIRECT.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, KY, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20201021001166 NC Practitioner - Emergency Medicine 8022438647 Reassigns benefits to 2 organizations
I20210726001626 KY Practitioner - Emergency Medicine 8022438647 Reassigns benefits to 3 organizations
I20250814002269 WI Practitioner - Emergency Medicine 8022438647 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Midwestern University, Chicago College of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

10101 S 27TH St
Franklin, WI 53132-7209
Phone (414) 325-4700

13111 N Port Washington Rd
Mequon, WI 53097-2416
Phone (262) 243-7300

19333 W N Ave
Brookfield, WI 53045-4132
Phone (262) 785-2000

201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone (414) 259-7200

2301 N Lake Dr
Milwaukee, WI 53211-4508
Phone (414) 291-1000

3237 S 16TH St
Milwaukee, WI 53215-4526
Phone (414) 647-5000

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018-01812NCMDEmergency Medicine Physician
81899WIMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Thedacare Medical Center - New London, Inc CurrentSince Aug 10, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Emergency Medicine CurrentSince Aug 10, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince Aug 10, 2025 Accepting new patients
The Carolinas Emergency Group, PLLC Emergency Medicine CurrentSince Sep 15, 2020 Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 1, 2025 Accepting new patients
New Lexington Clinic PSC CurrentSince Oct 11, 2023 Accepting new patients
Pikeville Medical Center Inc. CurrentSince Aug 1, 2021 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Jan 3, 2026 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Community Medical Associates, Inc. Current Accepting new patients
Pikeville Medical Center Inc CurrentSince Aug 1, 2021 Accepting new patients
Robeson Emergency Physicians, PLLC Emergency Medicine CurrentSince Jan 1, 2021 Accepting new patients
Mercy Health System Corporation CurrentSince Nov 1, 2025 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Thedacare Medical Center - Berlin, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Community Medical Associates, Inc. CurrentSince Apr 1, 2024 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Emergency Medicine Specialists, S.C. Emergency Medicine CurrentSince Sep 1, 2025 Accepting new patients
New Lexington Clinic, PSC CurrentSince Oct 11, 2023 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Aug 10, 2025 Accepting new patients
Thedacare Medical Center - New London, Inc. CurrentSince Jan 1, 2026 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

800 Tilghman Dr
Dunn, NC 28334
Phone (910) 230-7800

300 W 27th St
Lumberton, NC 28358
Phone (910) 671-5000

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

225 Memorial Dr
Berlin, WI 54923
Phone (920) 361-1313

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

1405 Mill St
New London, WI 54961
Phone (920) 531-2000

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

323 S 18th Ave
Sturgeon Bay, WI 54235
Phone (920) 743-5566

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

10625 W North Ave
Ste 101
Wauwatosa, WI 53226
Phone (414) 858-2200

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: apevtsov21686@pikevillekydirect.org

Organizations & group practices 24

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.

View all 24

Hospital & facility affiliations 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1376071001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-218-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W 27TH ST",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-735-8783"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "911 Bypass Rd Bldg A",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415011689",
            "country_code": "US",
            "telephone_number": "606-430-3500",
            "fax_number": "606-437-0595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Audubon Plaza Dr",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171318",
            "country_code": "US",
            "telephone_number": "502-636-7225",
            "fax_number": "502-636-8032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811943",
            "country_code": "US",
            "telephone_number": "715-258-1041",
            "fax_number": "715-258-1042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEVTSOV",
        "first_name": "ALEKSANDR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-25",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2018-01812",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "81899",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "04931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apevtsov21686@PIKEVILLEKYDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "Direct address for ccda",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Standard direct functionality",
            "address_1": "911 Bypass Rd Bldg A",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415011689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lumberton, NC

Sources for this page

Verify at the official NPI Registry.