Andriy Pavlenko, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

25MA08321600 Issued in NJ

Practice address

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048

Phone

(856) 488-6560

Fax

(856) 488-6846

NPI assigned

Jan 22, 2009

Last updated

Apr 5, 2016By 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NJ

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

Pathology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Coyle S Connolly DO PAGroup PAC ID 2961498118, 32 clinicians

Aesthetic Dermatology LLCGroup PAC ID 2668437013, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086
• Thomas Jefferson University Hospital Hospital, Philadelphia, PA, CCN 390174

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Coyle S Connolly DO PA

  • Dermatology Physician
  • Linwood, NJ
  • NPI 1053367516
  Medicare reassignment Care Compare group NPD
• Kennedy Medical Group Practice, P.C.

  dba Jefferson Health

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  Medicare reassignment Care Compare group NPD
• Aesthetic Dermatology, LLC

  • Dermatology Physician
  • Marlton, NJ
  • NPI 1750449104
  Medicare reassignment Care Compare group
• Kennedy Medical Group Practice PC

  dba Kennedy Health Alliance

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD
• Oleg Volchonok, MD, PC

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1790951390
  NPD
• Pathology Solutions LLC

  • Clinical Medical Laboratory
  • Eatontown, NJ
  • NPI 1417924424
  NPD (past)
• Laboratory of Dermatopathology Adx, LLC

  • Dermatopathology (Pathology) Physician
  • Woodbury, NY
  • NPI 1487663860
  NPD (past)
• Retinovitreous Associates LTD

  • Ophthalmology Physician
  • Wilmington, DE
  • NPI 1952552630
  NPD (past)
• Tasker Healthcare Group PC

  dba Skinsmart Dermatology

  • Specialist
  • Wyndmoor, PA
  • NPI 1265584577
  NPD (past)

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

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation
• Thomas Jefferson University Hospitals Inc

  • General Acute Care Hospital
  • Philadelphia, PA
  • NPI 1215916002
  Care Compare affiliation

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459814400000",
    "number": "1932347440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022048",
            "telephone_number": "856-488-6560",
            "fax_number": "856-488-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 CHAPEL AVE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022048",
            "telephone_number": "856-488-6560",
            "fax_number": "856-488-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLENKO",
        "first_name": "ANDRIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2016-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NJ",
            "license": "25MA08321600",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "244058",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201529",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00755920",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhona Paul-Cohen, M.S.,CC-SP
• Priscilla A Paulin, RN,CS
• Melanie Paulino, OT
• Amanda Paull, MS, OTR/L
• Kristi Cheney Paulson, MSW, LSW,
• Pax Lumen Behavioral Health Solutions, LLC
• Eden Christine Payabyab
• Jaime Catindig Paz, RN
• Peaceful Soul Therapeutic Services
• Franklin John Pearce

• Anatomic Pathology & Clinical Pathology Physician in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Anatomic Pathology & Clinical Pathology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; 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.