Dmytro M Havaleshko, MD
Individual provider Active NPI Surgery Physician · Dover, NH
NPI 1770745580 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1770745580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 15959 (NH)
- Practice address
- 789 Central Ave
Dover, NH 03820-2526 - Phone
- (603) 610-8095
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wentworth Douglass Physician Corporation
Practice addresses (Care Compare)
789 Central Ave
Level2
Dover, NH 03820-2526
Phone (603) 609-6096
Hospital & facility affiliations
- Wentworth-Douglass Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 13 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 18 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130904000725 | NH | Practitioner - General Surgery | 6901042902 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15959 | NH | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wentworth Douglass Physician Corporation | Current |
Accepting new patients | |
| Wentworth Douglass Physician Corporation | Current |
Accepting new patients | |
| Wentworth Douglass Hospital | Current | Accepting new patients | |
| Westchester Neurological Consultant PC | Past | Accepting new patients | |
| Wentworth Douglass Hospital | Past | Accepting new patients |
Locations
789 Central Ave
#2
Dover, NH 03820
Phone (603) 740-2503
750 Central Ave
Ste Q
Dover, NH 03820
Phone (603) 742-6030
789 Central Ave
#1
Dover, NH 03820
Phone (603) 609-6260
10 Members Way
Ste 302
Dover, NH 03820
Phone (603) 610-8095
789 Central Ave
Dover, NH 03820
Phone (603) 740-2832
Interoperability endpoints
- havaleshko.dmytro.wdh@direct.partners.masshiway.net
- https://fhir.meditouchehr.com/api/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 15959 | NH | Yes |
Addresses
Primary practice location
789 Central Ave
Dover, NH 03820-2526
Mailing address
789 Central Ave
Dover, NH 03820-2526
Phone (603) 610-8095
Other practice location 1
330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-4174
Phone (603) 431-5242
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3088218 | Medicaid | NH |
Other providers in Dover, NH
- Hillary Dawn Hartwick
- Yulius Leonard Haryadi
- Firas Hashim
- William E Hassett
- Shannon Hatch
- Chelsey Anna Hayes-Marino
- Adrienne Hayes
- Alexa Schimmel Hayes
- Elizabeth Haywood-Niler
- HCA Health Services of New Hampshire, Inc.
All providers in Dover, NH · Surgery Physician in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.