Individual provider Active NPI

Aleksandr Korniyenko, M.D.

  • Cardiovascular Disease Physician
  • Tyler, TX
National Provider Identifier
1881995983
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
Q3220 Issued in TX
Practice address
2608 McDonald Rd
Tyler, TX 75701-5934
Phone
(903) 595-5514
NPI assigned
Nov 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 49470 CT
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X Q3220 TX Primary

Addresses

Primary practice location

2608 McDonald Rd
Tyler, TX 75701-5934

Mailing address

901 Turtle Creek Dr
Tyler, TX 75701-1947
Phone (903) 596-3651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150902000983 TX Practitioner - Cardiovascular Disease (Cardiology) 6608046008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

2608 McDonald Rd
Tyler, TX 75701-5934
Phone (903) 595-5514

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Ut Health East Texas Carthage Hospital Hospital, Carthage, TX, CCN 450210
  • Ut Health East Texas Henderson Hospital Hospital, Henderson, TX, CCN 450475
  • Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
  • University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
  • Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. Cardiovascular Disease CurrentSince Mar 1, 2018 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley Past Accepting new patients
Starks Medical Past Accepting new patients

Locations

340 Seven Springs Way
Ste 100
Brentwood, TN 37027
Phone (615) 296-3000

115 Medical Cir
Ste 102
Athens, TX 75751
Phone (903) 676-5889

702 Davis St
Carthage, TX 75633
Phone (903) 693-3841

409 Cottage Rd
Carthage, TX 75633
Phone (903) 693-3841

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

2114 E Rusk St
Jacksonville, TX 75766
Phone (903) 284-6105

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

2608 McDonald Rd
Tyler, TX 75701
Phone 903595551487262

2401 Sse Loop 323
Tyler, TX 75701
Phone (903) 510-7212

901 Turtle Creek Dr
Tyler, TX 75701
Phone (903) 594-2418

Interoperability endpoints

  • Direct secure messaging: akorniyenko355179@ahs.direct-ci.com

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 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": "1289001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1881995983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 TURTLE CREEK DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011947",
            "telephone_number": "903-596-3651",
            "fax_number": "903-594-2038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 MCDONALD RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015934",
            "telephone_number": "903-595-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNIYENKO",
        "first_name": "ALEKSANDR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-06",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CT",
            "license": "49470",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "Q3220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.