Individual provider Active NPI

Svetlana Feytser Tishchenko

  • Family Medicine Physician
  • Lebanon, OR
National Provider Identifier
1821493412
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS021289 Issued in PA
Practice address
200 Mullins Dr
Lebanon, OR 97355-3983
Phone
(360) 910-2384
NPI assigned
Oct 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS021289 PA Primary

Addresses

Primary practice location

200 Mullins Dr
Lebanon, OR 97355-3983

Mailing address

200 Mullins Dr
Lebanon, OR 97355-3983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210915003208 PA Practitioner - HospitalistPractitioner - Family Practice 2668879750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

232 W 25TH St
Erie, PA 16544-0002
Phone (814) 452-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.42 of 100Reported as group
Quality
75.58
Improvement activities
40
Cost
72.74

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group of Pennsylvania PC CurrentSince Aug 30, 2021 Accepting new patients
Apogee Medical Group of Pennsylvania PC CurrentSince Aug 30, 2021 Accepting new patients
Saint Vincent Health Center Past Accepting new patients

Locations

15059 N Scottsdale Rd
Ste 600
Scottsdale, AZ 85254
Phone (602) 778-3601

232 W 25th St
Erie, PA 16544
Phone (814) 452-5337

1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540

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": "1414195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1821493412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MULLINS DR",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973553983",
            "telephone_number": "360-910-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEYTSER TISHCHENKO",
        "first_name": "SVETLANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-25",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, OR

Sources for this page

Verify at the official NPI Registry.