NPIMap

Individual provider Active NPI

Yevgeniy Vayntrub, MD

  • Student in an Organized Health Care Education/Training Program
  • Camden, NJ
National Provider Identifier
1811254584
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1 Cooper PLZ
Camden, NJ 08103-1461
Phone
(856) 342-2000
NPI assigned
Apr 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD61184072 WA
Pulmonary Disease Physician 207RP1001X MD61184072 WA

Addresses

Primary practice location

1 Cooper PLZ
Camden, NJ 08103-1461

Mailing address

1 Cooper PLZ
Camden, NJ 08103-1461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220107001059 WA Practitioner - Pulmonary Disease 6800174087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Icahn School of Medicine at Mount Sinai, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1708 Yakima Ave
Suite 300
Tacoma, WA 98405-5307

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
142606CAMDMarriage & Family Therapist
MD61184072WAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Internal Medicine Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34515 9th Ave S
#136
Federal Way, WA 98003

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1708 Yakima Ave
Ste 300
Tacoma, WA 98405
Phone (253) 363-8700

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

2420 S State St
Tacoma, WA 98405
Phone (253) 426-4000

Interoperability endpoints

  • Direct secure messaging: yvayntrub721140@fhsce.catholichealth.net

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 10

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1811254584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COOPER PLZ",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031461",
            "telephone_number": "856-342-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNTRUB",
        "first_name": "YEVGENIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD61184072",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD61184072",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

Verify at the official NPI Registry.