Individual provider Active NPI

Vladimir Yefremov, PAC

  • Physician Assistant
  • New Port Richey, FL
National Provider Identifier
1649285230
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
103553 Issued in NC
Practice address
5637 Marine Pkwy
New Port Richey, FL 34652-4316
Phone
(727) 845-9115
Fax
(727) 834-5619
NPI assigned
Jul 30, 2006
Last updated
Jun 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 103553 NC Primary
Physician Assistant 363A00000X PA9103394 FL

Addresses

Primary practice location

5637 Marine Pkwy
New Port Richey, FL 34652-4316

Mailing address

2832 Ravendale LN
Holiday, FL 34691-7837
Phone (727) 934-4195

Other practice location 1

825 Spartanburg Hwy Ste 17
Hendersonville, NC 28792-4770
Phone (828) 233-1664

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000735 NC Practitioner - Physician Assistant 7911920616 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fastmed PCGroup PAC ID 9830540558, 174 clinicians

Practice addresses (Care Compare)

160 Hendersonville Rd
Asheville, NC 28803-2680
Phone (828) 210-2835

511 Smokey Park Hwy
Candler, NC 28715-8613
Phone (828) 365-1088

7010 NC Hwy 751
Durham, NC 27707-5733
Phone (919) 313-3900

825 Spartanburg Hwy
Suite 17
Hendersonville, NC 28792-4770
Phone (828) 233-1664

Merit-based Incentive Payment System (MIPS)

Final score
74.09 of 100Reported as group
Quality
65.78
Improvement activities
40
Cost
76.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9103394FLMDPhysician Assistant
103553NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Mountain Emergency Medicine PA CurrentSince Aug 1, 2010 Accepting new patients
Franklin Regional Emergency Physicians PLLC CurrentSince Apr 16, 2017 Accepting new patients
Emergency Coverage Services, PC Physician Assistant Past Accepting new patients
Osprey Emergency Physicians LLC Past Accepting new patients
Quality Drive Emergency Physicians LLC Past Accepting new patients
Sabal Palm Emergency Physicians Past Accepting new patients
Clyde Emergency Solutions LLC Past Accepting new patients
Pasco Emergency Physicians LLC Past Accepting new patients
Florida Em-I Medical Services PA Past Accepting new patients
Fastmed Primary Care, P.C. Past Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

430 Rankin Dr
Marion, NC 28752
Phone (828) 652-2125

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

Organizations & group practices 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1649285230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 RAVENDALE LN",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346917837",
            "telephone_number": "727-934-4195",
            "fax_number": "727-507-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5637 MARINE PKWY",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524316",
            "telephone_number": "727-845-9115",
            "fax_number": "727-834-5619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Spartanburg Hwy Ste 17",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287924770",
            "country_code": "US",
            "telephone_number": "828-233-1664",
            "fax_number": "828-696-4047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YEFREMOV",
        "first_name": "VLADIMIR",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103553",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9103394",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

Verify at the official NPI Registry.