NPIMap

Individual provider Active NPI

Oksana Yevdokimova, MD

  • Family Medicine Physician
  • Washington, NJ
National Provider Identifier
1437290772
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MA8408900 Issued in NJ
Practice address
315 Route 31 South
Washington, NJ 07882-4327
Phone
(908) 689-0777
Fax
(908) 835-3037
NPI assigned
Feb 9, 2007
Last updated
Sep 10, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MA8408900 NJ Primary

Addresses

Primary practice location

315 Route 31 South
Washington, NJ 07882-4327

Mailing address

PO Box 27957
Salt Lake City, UT 84127-0957
Phone (908) 689-0777

Other identifiers 1

IdentifierTypeStateIssuer
0179949MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000279 NJ Practitioner - Family Practice 3870655244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

315 State Route 31 S
Washington, NJ 07882-4069
Phone (908) 847-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA8408900NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Warren Physician Group, PC Family Medicine Current Accepting new patients
St. Luke's Warren Physician Group, PC CurrentSince Jul 1, 2008 Accepting new patients
St. Luke's Warren Physician Group, PC Family Medicine CurrentSince Jul 1, 2008 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients
St. Luke's Warren Hospital, Inc. Past Accepting new patients

Locations

409 Coventry Dr
Phillipsburg, NJ 08865
Phone (908) 213-0029

315 State Route 31 S
Washington, NJ 07882
Phone (908) 689-0777

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 5

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1437290772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27957",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270957",
            "telephone_number": "908-689-0777",
            "fax_number": "908-835-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ROUTE 31 SOUTH",
            "city": "WASHINGTON",
            "state": "NJ",
            "postal_code": "078824327",
            "telephone_number": "908-689-0777",
            "fax_number": "908-835-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEVDOKIMOVA",
        "first_name": "OKSANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA8408900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0179949",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NJ

Sources for this page

Verify at the official NPI Registry.