Individual provider Active NPI

Andrei V. Manilchuk, MD

  • Surgery Physician
  • Columbus, OH
National Provider Identifier
1699728873
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35082381 Issued in OH
Practice address
2050 Kenny Rd
Columbus, OH 43221-3502
Phone
(614) 293-7171
Fax
(614) 366-0003
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35082381 OH Primary

Addresses

Primary practice location

2050 Kenny Rd
Columbus, OH 43221-3502

Mailing address

700 Ackerman Rd Ste 2120
Columbus, OH 43202-1559
Phone (614) 293-7171

Other identifiers 1

IdentifierTypeStateIssuer
2405221MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amanilchuk5153@direct.osumc.edu

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240724004420 OH Practitioner - General Surgery 6305833948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Physicians LLCGroup PAC ID 3971506932, 56 clinicians

Practice addresses (Care Compare)

425 W 5TH St
East Liverpool, OH 43920-2405
Phone (330) 385-2926

Hospital & facility affiliations

  • East Liverpool City Hospital Hospital, East Liverpool, OH, CCN 360096

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy21
Upper gastrointestinal (GI) endoscopy for acid reflux27
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35082381OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Physicians, LLC CurrentSince May 13, 2024 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Openloop Healthcare Partners PC Past Accepting new patients

Locations

15655 State Route 170
Ste H
East Liverpool, OH 43920
Phone (330) 932-0183

15655 State Route 170
Ste B
East Liverpool, OH 43920
Phone (330) 386-3610

425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBJFBA

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1699728873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-7171",
            "fax_number": "614-366-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 KENNY RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213502",
            "telephone_number": "614-293-7171",
            "fax_number": "614-366-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANILCHUK",
        "first_name": "ANDREI",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35082381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2405221",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanilchuk5153@direct.osumc.edu",
            "affiliation": "N",
            "address_1": "2050 Kenny Rd",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432213502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.