NPIMap

Individual provider Active NPI

Vladislav Mordach, DO

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1386273829
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS18931 Issued in FL
Practice address
28 Stryker CT
Brooklyn, NY 11223-5227
Phone
(347) 675-7007
NPI assigned
Apr 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X U3602 TX
Emergency Medicine Physician 207P00000X OS18931 FL Primary

Addresses

Primary practice location

28 Stryker CT
Brooklyn, NY 11223-5227

Mailing address

28 Stryker CT
Brooklyn, NY 11223-5227
Phone (347) 675-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, VA, DC, CA4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20230825000007 TX Practitioner - Emergency Medicine 3375965387 Reassigns benefits to 2 organizations
I20231025003018 VA Practitioner - Emergency Medicine 3375965387 Reassigns benefits to 2 organizations
I20241202002370 DC Practitioner - Emergency Medicine 3375965387 Reassigns benefits to 2 organizations
I20260122000195 CA Practitioner - Emergency Medicine 3375965387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2204 Wilborn Ave
South Boston, VA 24592-1645
Phone (434) 517-3660

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
75.4
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24188CAMDClinical Social Worker
OS18931FLMDEmergency Medicine Physician
U3602TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Emergency Medicine CurrentSince Jun 1, 2025 Accepting new patients
Mep Health, LLC Emergency Medicine CurrentSince Sep 11, 2023 Accepting new patients
Emergency Medicine Associates, PA Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine CurrentSince Feb 1, 2025 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Nov 1, 2024 Accepting new patients
Sonoma Valley Emergency Physicians Medical Group, Inc Emergency Medicine CurrentSince Nov 13, 2025 Accepting new patients
Emergency Medicine Associates, P.a.,P.C. Current Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Jun 10, 2024 Accepting new patients
Alexandria Springfield Emergency Physicians PC Emergency Medicine Current Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jul 15, 2023 Accepting new patients

Locations

1375 University St
Healdsburg, CA 95448
Phone (707) 385-2025

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

4320 Seminary Rd
Alexandria, VA 22304
Phone (703) 504-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

500 Martha Jefferson Dr
Charlottesvle, VA 22911
Phone (434) 654-7000

15225 Heathcote Blvd
Haymarket, VA 20169
Phone (571) 284-1000

8700 Sudley Rd
Manassas, VA 20110
Phone (703) 369-8000

2204 Wilborn Ave
South Boston, VA 24592
Phone (434) 517-3100

Organizations & group practices 10

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1386273829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 STRYKER CT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235227",
            "telephone_number": "347-675-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 STRYKER CT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112235227",
            "telephone_number": "347-675-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORDACH",
        "first_name": "VLADISLAV",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U3602",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS18931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.