Individual provider Active NPI

Yuri O Shevchenko, M.D.

  • Pediatric Anesthesiology Physician
  • Philadelphia, PA
National Provider Identifier
1588649214
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD059395L Issued in PA
Practice address
160 E Erie Ave
Philadelphia, PA 19134-1011
Phone
(215) 427-5520
NPI assigned
Dec 15, 2005
Last updated
May 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD059395L PA
Pediatric Anesthesiology Physician 207LP3000X MD059395L PA Primary

Addresses

Primary practice location

160 E Erie Ave
Philadelphia, PA 19134-1011

Mailing address

PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20040622001323 PA Practitioner - Anesthesiology 0042295107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
STC Pediatrics LLCGroup PAC ID 7315372323, 73 clinicians

Practice addresses (Care Compare)

160 E Erie Ave
Philadelphia, PA 19134-1011

300 E Hunting Park Ave
St Christophers Ped Assoc Child Protection
Philadelphia, PA 19124-6018
Phone (215) 427-8363

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD059395LPAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
STC Pediatrics LLC Current Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
STC Pediatrics LLC CurrentSince Dec 1, 2019 Accepting new patients
Anesthesia Specialists of Bethlehem, PC Anesthesiology CurrentSince Oct 26, 2021 Accepting new patients
Associates in Anesthesia, Inc. Anesthesiology CurrentSince Nov 15, 2018 Accepting new patients
Pinnacle Mid-Atlantic Anesthesia Associates PC Anesthesiology PastSince Sep 15, 2019 Accepting new patients
Anesthesia Specialists of Warren, LLC Anesthesiology Past Accepting new patients
SCHC Pediatric Associates, LLC Past Accepting new patients
Associates in Anesthesia Anesthesiology Past Accepting new patients
Premier Anesthesia of Pennsylvania PC Anesthesiology Past Accepting new patients
Professional Anesthesia Consultants, PC Anesthesiology PastSince Sep 14, 2011 Accepting new patients

Locations

1 W Broad St
Ste 506
Bethlehem, PA 18018
Phone 6109545810 ext. 3

153 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 526-3200

1212 Baltimore Pike
Ste 200
Chadds Ford, PA 19317
Phone (610) 874-4147

30 Medical Center Blvd
Ste 305
Chester, PA 19013
Phone (610) 619-7411

250 S 21st St
Easton, PA 18042
Phone (610) 250-4300

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

160 E Erie Ave
Philadelphia, PA 19134
Phone (215) 427-4067

300 E Hunting Park Ave
Philadelphia, PA 19124
Phone (215) 427-8363

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0d26bd04-9128-4f58-8e6d-ffda5cd00f89/

Organizations & group practices 11

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1588649214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEVCHENKO",
        "first_name": "YURI",
        "middle_name": "O",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD059395L",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD059395L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.