NPIMap

Individual provider Active NPI

Victor Lawrinenko, MD

  • Gastroenterology Physician
  • Poplar Bluff, MO
National Provider Identifier
1831134436
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
31984 Issued in IA
Practice address
3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone
(573) 776-2600
NPI assigned
Jun 18, 2006
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31984 IA
Gastroenterology Physician 207RG0100X 31984 IA Primary

Addresses

Primary practice location

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573

Mailing address

2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590

Other practice location 1

3098 Oak Grove Rd
Poplar Bluff, MO 63901-8938
Phone (573) 778-2600

Other identifiers 1

IdentifierTypeStateIssuer
0158519MedicaidIA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address victor.lawrinenko.1@8825.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20150504001844 MO Practitioner - Gastroenterology 0143293100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Eastern Virginia Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poplar Bluff Hma Physician Management, LLCGroup PAC ID 5092769703, 41 clinicians

Practice addresses (Care Compare)

3098 Oak Grove Rd
Poplar Bluff, MO 63901-8938
Phone (855) 444-7276

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as apm
Quality
79.26
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy367
Upper gastrointestinal (GI) endoscopy for acid reflux1020

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31984IAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Bluff Hma Physician Management, LLC Gastroenterology CurrentSince Apr 1, 2015 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

3098 Oak Grove Rd
Poplar Bluff, MO 63901
Phone (573) 778-2600

621 W Pine St
Poplar Bluff, MO 63901
Phone (573) 686-4111

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1831134436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK GROVE RD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639011573",
            "telephone_number": "573-776-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3098 Oak Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Poplar Bluff",
            "state": "MO",
            "postal_code": "639018938",
            "country_code": "US",
            "telephone_number": "573-778-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAWRINENKO",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "31984",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IA",
            "license": "31984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0158519",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victor.lawrinenko.1@8825.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR Direct Address",
            "address_1": "3100 Oak Grove Rd",
            "city": "Poplar Bluff",
            "state": "MO",
            "country_code": "US",
            "postal_code": "639011573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.