Individual provider Active NPI

Pavlo I Netrebko, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Cary, NC
National Provider Identifier
1629240395
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
200900690 Issued in NC
Practice address
300 Keisler Dr
Suite 204
Cary, NC 27518-7083
Phone
(919) 233-0059
Fax
(919) 233-0343
NPI assigned
Apr 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 200900690 NC
Clinical Cardiac Electrophysiology Physician 207RC0001X 200900690 NC Primary

Addresses

Primary practice location

300 Keisler Dr
Suite 204
Cary, NC 27518-7083

Mailing address

300 Keisler Dr
Suite 204
Cary, NC 27518-7083
Phone (919) 233-0059

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pnetrebko11728@directHISP.wakemed.org Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000563 NC Practitioner - Cardiac ElectrophysiologyPractitioner - Cardiovascular Disease (Cardiology) 2264504661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Medical College of Pennsylvania, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

300 Keisler Dr
Cary, NC 27518-7083
Phone (919) 350-0554

Hospital & facility affiliations

  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173
  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200900690NCMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Medical Laboratory Consultants Inc Current Accepting new patients
Wakemed CurrentSince Nov 23, 2010 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Oct 1, 2024 Accepting new patients
Wakemed CurrentSince Nov 23, 2010 Accepting new patients
Wakemed Specialists Group LLC Cardiovascular Disease CurrentSince Oct 1, 2024 Accepting new patients
Wakemed Specialists Group, LLC Cardiovascular Disease Current Accepting new patients
Cary Cardiology Associates PastSince Jan 1, 1990 Accepting new patients

Locations

1 Medical Dr
Benson, NC 27504
Phone (919) 207-1027

300 Keisler Dr
Ste 204
Cary, NC 27518
Phone (919) 233-0059

300 Keisler Dr
Cary, NC 27518
Phone (919) 230-4434

145 Tilghman Dr
Dunn, NC 28334
Phone (910) 891-7007

400 Attain St
Fuquay Varina, NC 27526
Phone (984) 377-8675

400 US 70 Hwy E
Garner, NC 27529
Phone (919) 235-6400

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

3024 New Bern Ave
Fl 3
Raleigh, NC 27610
Phone (919) 350-0558

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

Interoperability endpoints

  • Direct secure messaging: pnetrebko11728@directhisp.wakemed.org

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1629240395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 KEISLER DR",
            "address_2": "SUITE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187083",
            "telephone_number": "919-233-0059",
            "fax_number": "919-233-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 KEISLER DR",
            "address_2": "SUITE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187083",
            "telephone_number": "919-233-0059",
            "fax_number": "919-233-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETREBKO",
        "first_name": "PAVLO",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200900690",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NC",
            "license": "200900690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pnetrebko11728@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "300 Keisler Dr",
            "address_2": "Suite 204",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275187083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.