Active NPI
Georgiy O Bondarchuk, DIVE IDC
- Independent Duty Corpsman
- Everett, WA
National Provider Identifier
1376176594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 2000 W Marine View Dr BLDG 2202
Everett, WA 98207-5000 - Phone
- (425) 304-5504
- NPI assigned
- Feb 17, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
2000 W Marine View Dr BLDG 2202
Everett, WA 98207-5000
Mailing address
18151 68TH Ave NE Apt 317
Kenmore, WA 98028-2834
Phone (425) 304-5504
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801350442 | Other | NPPES |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | georgiy.o.bondarchuk.mil@us.navy.mil | ||
| Direct Messaging Address | georgiy.bondarchuk1@navy.mil | Health Information Exchange (HIE) |
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
Interoperability endpoints
- georgiy.o.bondarchuk.mil@us.navy.mil
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1376176594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18151 68TH AVE NE APT 317",
"city": "KENMORE",
"state": "WA",
"postal_code": "980282834",
"telephone_number": "425-304-5504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 W MARINE VIEW DR BLDG 2202",
"city": "EVERETT",
"state": "WA",
"postal_code": "982075000",
"telephone_number": "425-304-5504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONDARCHUK",
"first_name": "GEORGIY",
"middle_name": "O",
"credential": "DIVE IDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-17",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES",
"identifier": "1801350442",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "georgiy.o.bondarchuk.mil@us.navy.mil",
"affiliation": "N",
"address_1": "2000 W Marine View Dr Bldg 2202",
"city": "Everett",
"state": "WA",
"country_code": "US",
"postal_code": "982075000",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "georgiy.bondarchuk1@navy.mil",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1465 Hewitt Dr",
"city": "Virginia Beach",
"state": "VA",
"country_code": "US",
"postal_code": "234598523",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.