NPIMap

Individual provider Active NPI

Dimitri D Kuznetsov, MD

  • Urology Physician
  • Port Townsend, WA
National Provider Identifier
1659473825
Registry record updated Dec 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00042014 Issued in WA
Practice address
1274 7TH St
Suite B
Port Townsend, WA 98368
Phone
(360) 385-2905
Fax
(360) 385-6796
NPI assigned
Sep 1, 2006
Last updated
Dec 29, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD00042014 WA Primary

Addresses

Primary practice location

1274 7TH St
Suite B
Port Townsend, WA 98368

Mailing address

PO Box 555
Port Townsend, WA 98368
Phone (360) 385-5852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040907001073 WA Practitioner - Urology 1456327808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
New York University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1274 7TH St
Suite B
Port Townsend, WA 98368-2404
Phone (360) 385-2905

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.09 of 100Reported as apm
Quality
68.03
Promoting interoperability
81
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042014WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince May 1, 2015 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince May 1, 2015 Accepting new patients
Jefferson County Public Hospital District No 2 Urology Past Accepting new patients

Locations

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

1274 7th St
#B
Port Townsend, WA 98368
Phone (360) 385-2905

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198886400000",
    "number": "1659473825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1274 7TH ST",
            "address_2": "SUITE B",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "98368",
            "telephone_number": "360-385-2905",
            "fax_number": "360-385-6796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZNETSOV",
        "first_name": "DIMITRI",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD00042014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.