Organization Active NPI

Nataliya Dementovych MD PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Meadowbrook, PA
National Provider Identifier
1609737907
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
NATALIYA DEMENTOVYCH MD PLLC
Practice address
1711 Stocton Rd
Meadowbrook, PA 19046-1161
Phone
(267) 847-5245
NPI assigned
Nov 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Authorized official

Name
Dr. Nataliya Dementovych, MDNPI 1083875637
Title
Attending Physician
Phone
(267) 847-5245

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

1711 Stocton Rd
Meadowbrook, PA 19046-1161

Mailing address

1711 Stocton Rd
Meadowbrook, PA 19046-1161
Phone (267) 847-5245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260604002549 PA Part B Supplier - Clinic/Group Practice 3870064488 Receives reassigned benefits from 1 practitioner
Practice locations: Gwynedd, PA; Lafayette Hill, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1609737907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 STOCTON RD",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190461161",
            "telephone_number": "267-847-5245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 STOCTON RD",
            "city": "MEADOWBROOK",
            "state": "PA",
            "postal_code": "190461161",
            "telephone_number": "267-847-5245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATALIYA DEMENTOVYCH MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "DEMENTOVYCH",
        "authorized_official_first_name": "NATALIYA",
        "authorized_official_title_or_position": "ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "267-847-5245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadowbrook, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.