Individual provider Active NPI

Vladimir Medved

  • Pain Medicine Physician
  • Malone, NY
National Provider Identifier
1760572903
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
221956 Issued in NY
Practice address
24 4TH St
Malone, NY 12953-1350
Phone
(518) 481-6044
Fax
(518) 481-6043
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 221956 NY
Pain Medicine Physician 208VP0000X 221956 NY Primary

Addresses

Primary practice location

24 4TH St
Malone, NY 12953-1350

Mailing address

24 4TH St
Malone, NY 12953-1350
Phone (518) 481-6044

Other identifiers 5

IdentifierTypeStateIssuer
02410126MedicaidNY
5996910OtherNYGHI FAMILY HEALTH PLUS
364145OtherNYMVP HEALTH PLAN
P010221956OtherNYBLUE CROSS/BLUE SHIELD
P00189181OtherNYRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20051207000736 NY Practitioner - Pain ManagementPractitioner - Osteopathic Manipulative MedicinePractitioner - Family Practice 0547228629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alice Hyde Medical CenterGroup PAC ID 4082525837, 88 clinicians

Practice addresses (Care Compare)

133 Park St
Malone, NY 12953-1243

133 Park St
Malone, NY 12953-1244

134 Park St
Malone, NY 12953-1251
Phone (518) 481-2800

16 3Rd St a
Malone, NY 12953-1305
Phone (518) 481-2870

16 3Rd St B
Malone, NY 12953-1305
Phone (518) 481-2870

16 4TH St C
Malone, NY 12953-1340
Phone (518) 481-2896

183 Park St
Malone, NY 12953-1238

187 Park St
Suite 2
Malone, NY 12953-1233
Phone (518) 481-2790

20 4TH St
Suite 2
Malone, NY 12953-1339
Phone (518) 481-2677

23 4TH St
Malone, NY 12953-1331
Phone (518) 481-2880

23 Forth St
Suite 1
Malone, NY 12953-1238
Phone (518) 481-8080

24 4TH St
Suite 4
Malone, NY 12953-1350
Phone (518) 481-2632

45 6TH St
Malone, NY 12953-1246
Phone (518) 481-8000

969 State RT
Suite 11
Moira, NY 12957
Phone (518) 529-7847

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alice Hyde Medical Center Family Medicine CurrentSince Feb 29, 2016 Accepting new patients
Alice Hyde Medical Center Current Accepting new patients
Alice Hyde Medical Center Past Accepting new patients

Locations

20 4th St
#2
Malone, NY 12953
Phone (518) 481-2600

969 State Route 11
Moira, NY 12957
Phone (518) 529-7847

Interoperability endpoints

  • Direct secure messaging: vmedved205561@direct.uvmhealth.org

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1760572903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 4TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531350",
            "telephone_number": "518-481-6044",
            "fax_number": "518-481-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 4TH ST",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129531350",
            "telephone_number": "518-481-6044",
            "fax_number": "518-481-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDVED",
        "first_name": "VLADIMIR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "221956",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NY",
            "license": "221956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02410126",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI FAMILY HEALTH PLUS",
            "identifier": "5996910",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH PLAN",
            "identifier": "364145",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "P010221956",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00189181",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malone, NY

Sources for this page

Verify at the official NPI Registry.