NPIMap

Individual provider Active NPI

Vecheslav Fedorchenco, M.D.

  • Psychiatry Physician
  • Trophy Club, TX
National Provider Identifier
1750815189
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
R8350 Issued in TX
Practice address
2800 TX-114
Ste 350
Trophy Club, TX 76262
Phone
(817) 674-7983
NPI assigned
Apr 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry Physician 2084P0802X R8350 TX
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X R8350 TX Primary

Addresses

Primary practice location

2800 TX-114
Ste 350
Trophy Club, TX 76262

Mailing address

2800 TX-114
Ste 350
Trophy Club, TX 76262
Phone (817) 674-7983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715001831 TX Practitioner - Psychiatry 1759762123 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1440 Empire Central Dr
Dallas, TX 75247-4091
Phone (214) 645-3999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R8350TXMDAddiction Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kotel Atx PLLC CurrentSince Jun 7, 2022 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Feb 20, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Psychiatry CurrentSince Feb 20, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

5151 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-3000

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

2800 E Highway 114
Ste 350
Trophy Club, TX 76262
Phone (817) 490-7856

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

3001 Bee Caves Rd
Ste 220
West Lake Hills, TX 78746

Interoperability endpoints

  • Direct secure messaging: vfedorchenco146043@direct.phhs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 46

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1750815189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 TX-114",
            "address_2": "STE 350",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-674-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 TX-114",
            "address_2": "STE 350",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-674-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDORCHENCO",
        "first_name": "VECHESLAV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "TX",
            "license": "R8350",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "R8350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

Verify at the official NPI Registry.