Organization Active NPI

Valery D. Tarasenko, MD, Inc.

Doing business as Advanced Pain Management Institute

  • Interventional Pain Medicine Physician
  • Vacaville, CA
National Provider Identifier
1740478502
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
VALERY D. TARASENKO, MD, INC.
Doing business as
Advanced Pain Management Institute
Practice address
200 Butcher Rd
Vacaville, CA 95687-5616
Phone
(707) 359-2255
Fax
(707) 359-2259
NPI assigned
Oct 5, 2007
Last updated
Oct 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANCED PAIN MANAGEMENT INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Authorized official

Name
Valery D Tarasenko, MDNPI 1912981713
Title
MD
Phone
(707) 359-2255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

200 Butcher Rd
Vacaville, CA 95687-5616

Mailing address

200 Butcher Rd
Vacaville, CA 95687-5616
Phone (707) 359-2255

Other practice location 1

5255 Elkhorn Blvd
Sacramento, CA 95842-2506
Phone (916) 334-1100

Other names 1

  • Advanced Pain Management Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040817001344 CA Part B Supplier - Clinic/Group Practice 4880667864 Receives reassigned benefits from 4 practitioners
Practice locations: Sacramento, CA; Vacaville, CA
O20130426000198 CA DME Supplier - Physician - General Practice 4880667864 Practice locations: Vacaville, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1083858Advanced Pain Management Institute200 Butcher Road, Vacaville, CA 95687Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory
Part of
Valery D Tarasenko MD Inc

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729209600000",
    "number": "1740478502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BUTCHER RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875616",
            "telephone_number": "707-359-2255",
            "fax_number": "707-359-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BUTCHER RD",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956875616",
            "telephone_number": "707-359-2255",
            "fax_number": "707-359-2259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5255 Elkhorn Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958422506",
            "country_code": "US",
            "telephone_number": "916-334-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VALERY D. TARASENKO, MD, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED PAIN MANAGEMENT INSTITUTE",
        "enumeration_date": "2007-10-05",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A",
        "authorized_official_last_name": "TARASENKO",
        "authorized_official_first_name": "VALERY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "707-359-2255",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Pain Management Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Pain Management Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.