Individual provider Active NPI

Vitaly Pikarevich

  • Non-emergency Medical Transport (VAN)
  • San Francisco, CA
National Provider Identifier
1407090178
Registry record updated Apr 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
372401 Issued in CA
Practice address
1801 23Rd Ave
Suite 27
San Francisco, CA 94122-4452
Phone
(415) 706-4081
Fax
(415) 242-3251
NPI assigned
Apr 26, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 372401 CA Primary

Addresses

Primary practice location

1801 23Rd Ave
Suite 27
San Francisco, CA 94122-4452

Mailing address

501 Taraval St
San Francisco, CA 94116-2511
Phone (415) 706-4081

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

State licenses

LicenseStateTypeSpecialty
372401CAMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240704000000",
    "number": "1407090178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 TARAVAL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941162511",
            "telephone_number": "415-706-4081",
            "fax_number": "415-242-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 23RD AVE",
            "address_2": "SUITE 27",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941224452",
            "telephone_number": "415-706-4081",
            "fax_number": "415-242-3251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIKAREVICH",
        "first_name": "VITALY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-26",
        "last_updated": "2009-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "372401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.