Active NPI
Alexei Radiontchenko, MD
- Family Medicine Physician
- Kernersville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9801455
- Practice address
- 291 Broad St
Kernersville, NC 27284-2932 - Phone
- (336) 993-8181
- Fax
- (336) 996-9539
- NPI assigned
- Jul 13, 2006
- Last updated
- Mar 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9801455 | NC | Primary |
Addresses
Primary practice location
291 Broad St
Kernersville, NC 27284-2932
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 993-8181
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1189C | Other | NC | BCBS - CATAWBA |
| G91367 | Other | NC | UPIN |
| 891189C | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aradiontchenko5381@direct.novanthealth.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
291 Broad St
Kernersville, NC 27284-2932
Phone (336) 993-8181
Hospital & facility affiliations
- Medi Home Health & Hospice
- Well Care Home Health of the Triad Inc
- Novant Health Forsyth Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9801455 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forsyth Memorial Hospital, Inc. | Family Medicine | Current | Accepting new patients |
| Forsyth Memorial Hospital, Inc | Family Medicine | Current | Accepting new patients |
| Forsyth Memorial Hospital, Inc. | Current | Accepting new patients | |
| Forsyth Memorial Hospital, Inc | Family Medicine | Past | Accepting new patients |
Locations
6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473
291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181
7607 NC Highway 68 N
Ste B
Oak Ridge, NC 27310
Phone (336) 643-3378
100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560
Organizations & group practices 4
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.
-
dba NH Forsyth Primary Care Clinics
- Family Medicine Physician
- Winston Salem, NC
- NPI 1104548874
-
dba Novant Health Kernersville Family Medicine
- Family Medicine Physician
- Kernersville, NC
- NPI 1679531495
-
dba Novant Health Heart & Vascular Institute - Frontis Plaza
- Cardiovascular Disease Physician
- Winston Salem, NC
- NPI 1932935475
-
dba Novant Health Surry Medical Associates
- Family Medicine Physician
- Mount Airy, NC
- NPI 1295783108
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Novant Health Forsyth Medical Center
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1447200233
-
dba Medi Home Health Agency
- Home Health Agency
- Thomasville, NC
- NPI 1336323526
-
- Home Health Agency
- Advance, NC
- NPI 1952342784
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1619993946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751803",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751803",
"telephone_number": "336-993-8181",
"fax_number": "336-996-9539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 BROAD ST",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272842932",
"telephone_number": "336-993-8181",
"fax_number": "336-996-9539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADIONTCHENKO",
"first_name": "ALEXEI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2023-03-07",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "9801455",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - CATAWBA",
"identifier": "1189C",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "G91367",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891189C",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aradiontchenko5381@direct.novanthealth.org",
"affiliation": "N",
"address_1": "291 Broad St",
"city": "Kernersville",
"state": "NC",
"country_code": "US",
"postal_code": "272842932",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.