Individual provider Active NPI

Boris Cvetkovski, M.D.

  • Gastroenterology Physician
  • Raleigh, NC
National Provider Identifier
1801842976
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
200500025 Issued in NC
Practice address
2011 Falls Valley Dr
Suite 106
Raleigh, NC 27615-3452
Phone
(919) 870-1311
Fax
(919) 881-0822
NPI assigned
May 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 200500025 NC Primary

Addresses

Primary practice location

2011 Falls Valley Dr
Suite 106
Raleigh, NC 27615-3452

Mailing address

2011 Falls Valley Dr Ste 106
Raleigh, NC 27615-3452
Phone (919) 870-1311

Other identifiers 9

IdentifierTypeStateIssuer
2089911OtherNCCCN
5901202MedicaidNC
1380VOtherNCBLUE CROSS BLUE SHIELD
7138378OtherNCCIGNA
P00219685OtherNCRAILROAD MEDICARE
5593649OtherNCAETNA
1877717OtherNCUNITED HEALTHCARE
2089911OtherNCMAIL HANDLERS
D9864OtherNCMEDCOST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20050610000791 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 5890739858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
New York University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2011 Falls Valley Dr
Suite 106
Raleigh, NC 27615-3452
Phone (919) 870-1311

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy57
Upper gastrointestinal (GI) endoscopy for acid reflux23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200500025NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Healthcare PA CurrentSince Mar 14, 2005 Accepting new patients
Gastrointestinal Healthcare PA Gastroenterology CurrentSince Mar 14, 2005 Accepting new patients
Kennebec Gastrointestinal Assoc. Gastroenterology Past Accepting new patients

Locations

2011 Falls Valley Dr
Raleigh, NC 27615
Phone (919) 866-0002

2011 Falls Valley Dr
Ste 106
Raleigh, NC 27615
Phone (919) 870-1311

Interoperability endpoints

  • FHIR API: https://a1c02ddf-9398-4db3-b17d-e4ed406c88f2.gastro.prod.fhir.ema-api.com/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1801842976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2011 FALLS VALLEY DR STE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153452",
            "telephone_number": "919-870-1311",
            "fax_number": "919-881-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 FALLS VALLEY DR",
            "address_2": "SUITE 106",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276153452",
            "telephone_number": "919-870-1311",
            "fax_number": "919-881-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CVETKOVSKI",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "200500025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "2089911",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901202",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1380V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7138378",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00219685",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5593649",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1877717",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "2089911",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D9864",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.