Pavel Y Ivashchuk, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS040872 Issued in PA

Practice address

353 York St FRNT
Gettysburg, PA 17325-1955

Phone

(717) 334-8193

NPI assigned

May 24, 2016

Last updated

Mar 30, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Nov 10, 2016 through Nov 10, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1659729283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 WINDING WAY",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171096343",
            "telephone_number": "717-576-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 YORK ST FRNT",
            "city": "GETTYSBURG",
            "state": "PA",
            "postal_code": "173251955",
            "telephone_number": "717-334-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVASHCHUK",
        "first_name": "PAVEL",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Huff, PT
• Brooke Kathryn Hull
• Molly Hunt
• Emily I'Anson
• Integrative Pathways to Health & Healing LLC
• Brittany Leigh Jackson, MD
• Megan Jacobs
• Scott M Jaeger, M.D.
• Mary J. Jaromahum-Flaherty, M.D.
• Shanda Richelle Jefferson, LPC, NCC,ED.D

• General Practice Dentistry in Gettysburg, PA
• Providers in Gettysburg, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.