Semyon Maslovsky, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036077057 Issued in IL

Practice address

500 Park Ave
Ste 104
Lake Villa, IL 60046-6556

Phone

(847) 245-8700

Fax

(847) 245-8771

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Family Care of Lake County S.C.

  • Family Medicine Physician
  • Lake Villa, IL
  • NPI 1861485658
  Medicare reassignment NPD
• Eugene Pomeranets M.D.S.C.,

  • Family Medicine Physician
  • Lake Villa, IL
  • NPI 1679056618
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223942400000",
    "number": "1508855040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "address_2": "STE 104",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600466556",
            "telephone_number": "847-245-8700",
            "fax_number": "847-245-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "address_2": "STE 104",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600466556",
            "telephone_number": "847-245-8700",
            "fax_number": "847-245-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASLOVSKY",
        "first_name": "SEMYON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036077057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077057",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan R Magee, LCPC, CADC
• Magnolia Wellness Center
• Martin Pediatric Physical Therapy, Inc.
• Joy Suzann Martin, DPT
• Viktoriia V Martin, LPC
• Gabrielle Mazade, APRN, CNP
• Ashley J McDowell, SLP
• Mary McGinn
• Medical Care Center of Lake Villa
• Samantha Melillo

• Family Medicine Physician in Lake Villa, IL
• Providers in Lake Villa, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.