Vitaly Blatnoy, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME92940 Issued in FL

Practice address

7560 Red Bug Lake Rd Ste 1014
Oviedo, FL 32765-6591

Phone

(407) 706-1770

Fax

(407) 706-1777

NPI assigned

Oct 26, 2005

Last updated

Apr 25, 2024By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Dermatology

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Skin Cancer Surgery Center, LLCGroup PAC ID 3779866579, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: dermatologyandskincancercenter.vitalyblatnoy@140478.advancedmd-direct.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Dermatology and Skin Cancer Surgery Center, LLC

  dba Orlando Dermatology Center

  • Dermatology Physician
  • Oviedo, FL
  • NPI 1174078281
  Medicare reassignment Care Compare group Authorized official
• Dermacare Senior Solutions LLC

  • Nurse Practitioner
  • Lake Mary, FL
  • NPI 1972391357

  Dermatology

  Medicare reassignment NPD
• Dermatology and Skin Cancer Surgery Center, LLC

  dba Orlando Dermatology Center

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Oviedo, FL
  • NPI 1134617533

  Dermatology

  NPD Authorized official
• Florida Imaging Solutions, LLC

  • Sonography Radiologic Technologist
  • Oviedo, FL
  • NPI 1326202920
  Authorized official Same address or phone
• Associates in Dermatology Inc

  • Specialist
  • Kissimmee, FL
  • NPI 1316960297
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1669462123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 1014",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-706-1770",
            "fax_number": "407-706-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 1014",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-706-1770",
            "fax_number": "407-706-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4970 S US Highway 17/92",
            "address_purpose": "LOCATION",
            "city": "Casselberry",
            "state": "FL",
            "postal_code": "327073888",
            "country_code": "US",
            "telephone_number": "407-635-8012",
            "fax_number": "407-706-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "731 Strling Ctr Pl Unit 1931",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327465209",
            "country_code": "US",
            "telephone_number": "407-436-7375",
            "fax_number": "407-986-9007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 S Alafaya Trl Ste 26",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328288984",
            "country_code": "US",
            "telephone_number": "407-538-3855",
            "fax_number": "407-459-8732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLATNOY",
        "first_name": "VITALY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "FL",
            "license": "ME92940",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME92940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001633600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Birkmire Behavioral Healthcare, Inc
• BK III SE, Professional Association (Healthsource of Oviedo)
• Elizabeth Chapman Blackburn, OT
• Chelsea Blackwood, LCSW
• Careena Annia Blanc
• Robert Michael Bliss, D.M.D.
• Block Nation Chase Smolen Family Medicine Inc
• Bradley M Block, MD
• Bluefire Wellness LLC
• Eva Board, RBT

• Dermatology Physician in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.