Vadim Petrov-Kondratov, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

88065 Issued in GA

Practice address

604 W Oglethorpe Hwy
Hinesville, GA 31313-4415

Phone

(912) 910-3777

Fax

(912) 292-0005

NPI assigned

Mar 31, 2012

Last updated

May 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Interventional Pain Management

Education

University of Vermont College of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Treatment Centers of Georgia LLCGroup PAC ID 7012302425, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wayne Memorial Hospital Hospital, Jesup, GA, CCN 110124
• Candler Hospital Hospital, Savannah, GA, CCN 110024

Merit-based Incentive Payment System (MIPS)

Final score

93.67 of 100Reported as group

Quality

90

Improvement activities

40

Cost

75.92

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vadim.petrovkondratov@ptcga.eclinicaldirectplus.com

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.

• Pain Treatment Centers of Georgia LLC

  • Clinic/Center
  • Hinesville, GA
  • NPI 1548931249
  Medicare reassignment Care Compare group NPD Authorized official
• Pain Treatment Centers of Georgia LLC

  • Pain Clinic/Center
  • Richmond Hill, GA
  • NPI 1134909542
  Authorized official Same address or phone
• Pain Treatment Centers of Georgia LLC

  • Pain Medicine (Anesthesiology) Physician
  • Vidalia, GA
  • NPI 1447185129
  NPD (past) Authorized official
• Pain Treatment Centers of Georgia LLC

  • Pain Medicine (Anesthesiology) Physician
  • Jesup, GA
  • NPI 1447945407
  Authorized official Same address or phone
• Pain Treatment Centers of Georgia LLC

  • Pain Medicine Physician
  • Swainsboro, GA
  • NPI 1568327211
  NPD (past) Authorized official
• Pain Treatment Centers of Georgia LLC

  • Clinic/Center
  • Savannah, GA
  • NPI 1619702792
  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Hospital Authority of Wayne County, Georgia

  dba wayne memorial hospital

  • General Acute Care Hospital
  • Jesup, GA
  • NPI 1770578999
  Care Compare affiliation

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

{
    "created_epoch": "1333152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1891061040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134415",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134415",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Jesup",
            "state": "GA",
            "postal_code": "315457813",
            "country_code": "US",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3760 US Highway 17 Ste 11",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "GA",
            "postal_code": "313243378",
            "country_code": "US",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6606 Abercorn St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314055831",
            "country_code": "US",
            "telephone_number": "912-910-3777",
            "fax_number": "912-292-0005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROV-KONDRATOV",
        "first_name": "VADIM",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-31",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "GA",
            "license": "88065",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "AR",
            "license": "E10674",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": "88065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Christine Penney
• Kivetta Peoples
• Jina Perdue
• Amy Elizabeth Perkins-Murphy, LCSW
• Gabrielle Perry
• Phillips Pediatrics PC
• Donna Bowers Phillips, DDS
• Heidi Lynn Phillips
• Margaret Pietrucha
• Jessica Pimentel, FNP

• Interventional Pain Medicine Physician in Hinesville, GA
• Providers in Hinesville, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.