Individual provider Active NPI

Elena Lavrovskaya, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • San Antonio, TX
National Provider Identifier
1699973016
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD2021-0025 Issued in NM
Practice address
3300 Nacogdoches Rd
Suite 110
San Antonio, TX 78217-3373
Phone
(210) 646-0890
Fax
(210) 646-7764
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X M8779 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD2021-0025 NM Primary

Addresses

Primary practice location

3300 Nacogdoches Rd
Suite 110
San Antonio, TX 78217-3373

Mailing address

PO Box 681149
San Antonio, TX 78268-1149
Phone (210) 558-6288

Other practice location 1

4301 Northstar Way
Modesto, CA 95356-9535
Phone (209) 577-1200

Other identifiers 2

IdentifierTypeStateIssuer
197205102MedicaidTX
P00902944OtherTXMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM, CA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20080626000090 TX Practitioner - Pathology 7810069408 Reassigns benefits to 2 organizations
I20210226001585 NM Practitioner - Pathology 7810069408 Reassigns benefits to 2 organizations
I20230425002196 CA Practitioner - Pathology 7810069408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Pathology Associates LLPGroup PAC ID 6406851054, 25 clinicians

Practice addresses (Care Compare)

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 558-6288

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
53.37 of 100Reported as group
Quality
41.06
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2021-0025NMMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 1, 2022 Accepting new patients
Yosemite Pathology Medical Group, Inc Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2023 Accepting new patients
Unm Medical Group, Inc. CurrentSince Feb 16, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 1, 2022 Accepting new patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2023 Accepting new patients
Village Oaks Pathology Services, P.a. Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2011 Accepting new patients
Unm Medical Group Inc CurrentSince Feb 16, 2022 Accepting new patients
Village Oaks Pathology Services, P. a. CurrentSince Mar 1, 2011 Accepting new patients
Petroglyph Pathology Services, LLC Anatomic Pathology & Clinical Pathology PastSince Mar 4, 2021 Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients

Locations

4301 N Star Way
Ste A
Modesto, CA 95356

4301 N Star Way
Modesto, CA 95356
Phone 2095771200 ext. 212

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

301 E Miel de Luna Ave
Tucumcari, NM 88401
Phone (575) 461-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

12315 Judson Rd
Ste 114
Live Oak, TX 78233
Phone (210) 646-0890

7418 John Smith Dr
Ste 218
San Antonio, TX 78229
Phone (210) 614-0950

7400 Barlite Blvd
San Antonio, TX 78224
Phone (210) 921-2000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

3300 Nacogdoches Rd
Ste 110
San Antonio, TX 78217
Phone (210) 646-0890

4085 De Zavala Rd
Shavano Park, TX 78249

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

Organizations & group practices 10

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 4

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1699973016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681149",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782681149",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NACOGDOCHES RD",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782173373",
            "telephone_number": "210-646-0890",
            "fax_number": "210-646-7764"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 Northstar Way",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953569535",
            "country_code": "US",
            "telephone_number": "209-577-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVROVSKAYA",
        "first_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "M8779",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NM",
            "license": "MD2021-0025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197205102",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00902944",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.