Victoria Ivanukoff, DO

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

04487 Issued in KY

Practice address

1532 Lone Oak Rd Ste 405
Paducah, KY 42003-7942

Phone

(270) 441-4300

Fax

(270) 441-4370

NPI assigned

Jan 7, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Vascular SurgeryAlso: General Surgery

Education

New York College of Osteo Medicine of New York Institute of Technology, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102
• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Merit-based Incentive Payment System (MIPS)

Final score

89.3 of 100Reported as individual

Quality

68.01

Promoting interoperability

100

Improvement activities

40

Cost

84.34

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vivanukoff623680@direct.bsmhealth.org

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.

• Mercy Health Physicians Kentucky Specialty Care LLC

  • Surgery Physician
  • Paducah, KY
  • NPI 1700408093
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Kentucky Specialty Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Paducah, KY
  • NPI 1043088347
  NPD
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • Clinical Medical Laboratory
  • Paducah, KY
  • NPI 1245620640

  Hospital

  Care Compare affiliation
• Mercy Health-Lourdes Hospital LLC

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1346244126
  Care Compare affiliation

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553212800000",
    "number": "1598095929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 SOUTHCREST DR",
            "address_2": "STE 250",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816117",
            "telephone_number": "770-996-9945",
            "fax_number": "844-269-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD STE 405",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037942",
            "telephone_number": "270-441-4300",
            "fax_number": "270-441-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1035 SOUTHCREST DR",
            "address_2": "STE 250",
            "address_purpose": "LOCATION",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "country_code": "US",
            "telephone_number": "770-996-9945",
            "fax_number": "844-269-9596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1035 SOUTHCREST DR",
            "address_2": "STE 250",
            "address_purpose": "LOCATION",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "country_code": "US",
            "telephone_number": "770-996-9945",
            "fax_number": "844-269-9596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IVANUKOFF",
        "first_name": "VICTORIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2019-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "076643",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "KY",
            "license": "04487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vascular Surgery Physician in Paducah, KY
• Providers in Paducah, KY by specialty
• Vascular Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.