NPIMap

Organization Active NPI

Valery D. Tarasenko, MD, Inc.

Doing business as Advance pain management institute

  • Interventional Pain Medicine Physician
  • Sacramento, CA
National Provider Identifier
1649893009
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
VALERY D. TARASENKO, MD, INC.
Doing business as
Advance pain management institute
Practice address
5255 Elkhorn Blvd
Sacramento, CA 95842-2506
Phone
(916) 334-1100
NPI assigned
May 20, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Authorized official

Name
Mila Tarasenko
Title
Manager
Phone
(707) 359-2255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

5255 Elkhorn Blvd
Sacramento, CA 95842-2506

Mailing address

200 Butcher Rd
Vacaville, CA 95687-5616

Other names 1

  • Advance pain management institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604000116 CA DME Supplier - Physician - General Surgery 4880667864 Practice locations: Sacramento, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

5255 Elkhorn Blvd
Sacramento, CA 95842
Phone (707) 359-2255

Practitioners & affiliated clinicians

Practitioners 4

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": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1649893009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BUTCHER RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 ELKHORN BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958422506",
            "telephone_number": "916-334-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALERY D. TARASENKO, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "TARASENKO",
        "authorized_official_first_name": "MILA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "707-359-2255"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advance pain management institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.