Individual provider Active NPI

Vera Pochtarev, MD

  • Internal Medicine Physician
  • Rochester, MI
National Provider Identifier
1487183539
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
147406 Issued in FL
Practice address
1101 W University Dr
Rochester, MI 48307-1863
Phone
(248) 601-4805
Fax
(248) 601-4908
NPI assigned
Jun 11, 2017
Last updated
Nov 18, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4301112290 MI
Internal Medicine Physician 207R00000X 147406 FL Primary

Addresses

Primary practice location

1101 W University Dr
Rochester, MI 48307-1863

Mailing address

1811 W 14 Mile Rd Unit 206
Royal Oak, MI 48073-1757
Phone (414) 446-0481

Other identifiers 1

IdentifierTypeStateIssuer
4301112290OtherMIMEDICAL DOCTOR - EDUCATIONAL LIMITED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210127000193 FL Practitioner - Internal Medicine 0941574115 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
147406FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Broward Hospitalist Inc Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Florida Hospital Medicine Services, LLC. CurrentSince Dec 1, 2023 Accepting new patients

Locations

9655 Boynton Beach Blvd
Boynton Beach, FL 33472
Phone (561) 336-7000

201 E Sample Rd
Deerfield Beach, FL 33064
Phone (954) 786-6400

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

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.

NPI Registry JSON

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

{
    "created_epoch": "1497139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1487183539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 W 14 MILE RD UNIT 206",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731757",
            "telephone_number": "414-446-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071863",
            "telephone_number": "248-601-4805",
            "fax_number": "248-601-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POCHTAREV",
        "first_name": "VERA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-11",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301112290",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "147406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL DOCTOR - EDUCATIONAL LIMITED",
            "identifier": "4301112290",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

Verify at the official NPI Registry.