Individual provider Active NPI

Dimtcho V Popov, MD

  • Nephrology Physician
  • Monroe, LA
National Provider Identifier
1740289230
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
343543 Issued in LA
Practice address
711 Wood St Ste a
Monroe, LA 71201-7564
Phone
(318) 323-8847
Fax
(318) 387-8804
NPI assigned
Jul 18, 2005
Last updated
Jul 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 343543 LA Primary

Addresses

Primary practice location

711 Wood St Ste a
Monroe, LA 71201-7564

Mailing address

3368 Highway 280
Suite G-10
Alexander City, AL 35010-3393
Phone (256) 409-1500

Other identifiers 1

IdentifierTypeStateIssuer
529917040MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, LA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20070925000465 AL Practitioner - Internal MedicinePractitioner - Nephrology 0446228092 Reassigns benefits to 1 organization
I20250509003402 LA Practitioner - Nephrology 0446228092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Louisiana Kidney Specialists,LLCGroup PAC ID 5799748182, 8 clinicians

Practice addresses (Care Compare)

711 Wood St a
Monroe, LA 71201-7549
Phone (318) 323-8847

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20515AZMDCounselor
343543LAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alex City Internal Medicine & Nephrology Specialist CurrentSince May 7, 2014 Accepting new patients
Northeast Louisiana Kidney Specialists,LLC Nephrology CurrentSince Apr 10, 2025 Accepting new patients
Selma Nephrology Associates, PA Nephrology Past Accepting new patients
Fayette Medical Center Past Accepting new patients

Locations

3368 Highway 280
Ste 220
Alexander City, AL 35010
Phone (256) 409-1500

120 S Anniston Ave
Ste 124
Sylacauga, AL 35150
Phone (256) 409-1500

711 Wood St
Ste A
Monroe, LA 71201
Phone (318) 323-8847

Interoperability endpoints

  • Direct secure messaging: dpopov5339014@direct.casso.us.com
  • FHIR API: https://api.platform.athenahealth.com/26569/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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 6

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1740289230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3368 HIGHWAY 280",
            "address_2": "SUITE G-10",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103393",
            "telephone_number": "256-409-1500",
            "fax_number": "256-409-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 WOOD ST STE A",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712017564",
            "telephone_number": "318-323-8847",
            "fax_number": "318-387-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPOV",
        "first_name": "DIMTCHO",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "LA",
            "license": "343543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529917040",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.