Individual provider Active NPI

Aleksandr V. Mogilevski, MD

  • Neurology Physician
  • Winchester, KY
National Provider Identifier
1396896742
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
34010 Issued in KY
Practice address
128 Professional Ave
Winchester, KY 40391-1116
Phone
(859) 737-1300
Fax
(859) 737-1500
NPI assigned
Jan 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 34010 KY Primary

Addresses

Primary practice location

128 Professional Ave
Winchester, KY 40391-1116

Mailing address

128 Professional Ave
Winchester, KY 40391-1116
Phone (859) 737-1300

Other identifiers 1

IdentifierTypeStateIssuer
64340102MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000882 KY Practitioner - Neurology 4284893389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

128 Professional Ave
Winchester, KY 40391-1116
Phone (859) 737-1300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34010KYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Neurology,PSC Neurology CurrentSince Nov 1, 2002 Accepting new patients
Commonwealth Neurology Services, P.S.C. Neurology Past Accepting new patients

Locations

128 Professional Ave
Winchester, KY 40391
Phone (859) 737-1300

Organizations & group practices 2

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 1

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": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396896742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 PROFESSIONAL AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911116",
            "telephone_number": "859-737-1300",
            "fax_number": "859-737-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 PROFESSIONAL AVE",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403911116",
            "telephone_number": "859-737-1300",
            "fax_number": "859-737-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGILEVSKI",
        "first_name": "ALEKSANDR",
        "middle_name": "V.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "KY",
            "license": "34010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64340102",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

Verify at the official NPI Registry.