Individual provider Active NPI

Michael Ostapchuk, MD

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1972554822
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD56839 Issued in TN
Practice address
917 W Walnut St
Johnson City, TN 37604
Phone
(423) 439-6464
Fax
(423) 439-7118
NPI assigned
May 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27248 KY
Pediatrics Physician 208000000X 27248 KY
Family Medicine Physician 207Q00000X MD56839 TN Primary

Addresses

Primary practice location

917 W Walnut St
Johnson City, TN 37604

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 439-6464

Other practice location 1

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 989-4050

Other practice location 2

102 E Ravine Rd
Kingsport, TN 37660-3814
Phone (423) 245-9600

Other identifiers 2

IdentifierTypeStateIssuer
64272487MedicaidKY
200162470MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090529000249 KY Practitioner - Family Practice 0244389922 Reassigns benefits to 1 organization
I20180524002810 TN Practitioner - Family Practice 0244389922 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Dec 10, 2011 Accepting new patients
University of Louisville Physicians, Inc. Family Medicine Current Accepting new patients
Medical Education Assistance Corporation Family Medicine CurrentSince Jun 1, 2018 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Dec 10, 2011 Accepting new patients
University of Louisville Research Foundation Family Medicine Past Accepting new patients
Medical Education Assistance Corporation Family Medicine Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients
University Family Practice Assoc. PSC Family Medicine Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

215 Central Ave
Ste 100
Louisville, KY 40208
Phone (502) 588-8720

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

550 S Jackson St
Fl First
Louisville, KY 40202
Phone (502) 852-0011

1941 Bishop Ln
Ste 900
Louisville, KY 40218
Phone (502) 588-2500

550 S Jackson St
Fl 3
Louisville, KY 40202
Phone (502) 561-8850

501 E Broadway
Ste 290
Louisville, KY 40202
Phone (502) 217-5134

530 S Jackson St
Fl 2
Louisville, KY 40202
Phone (502) 561-8844

215 Central Ave
Ste 110
Louisville, KY 40208
Phone (502) 852-5205

550 S Jackson St
Louisville, KY 40202
Phone (502) 561-8686

550 S Jackson St
Fl 1
Louisville, KY 40202
Phone (502) 552-6503

530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000

171 E Lincoln Trail Blvd
Radcliff, KY 40160
Phone (270) 351-5367

917 W Walnut St
Johnson City, TN 37604
Phone (423) 439-6464

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

102 E Ravine Rd
Kingsport, TN 37660
Phone (423) 245-9600

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1972554822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 W WALNUT ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-6464",
            "fax_number": "423-439-7118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 E Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603814",
            "country_code": "US",
            "telephone_number": "423-245-9600",
            "fax_number": "423-245-9634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSTAPCHUK",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "27248",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "27248",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD56839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64272487",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200162470",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.