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Physician Compare National (NPI:1013367309)

HEALTHCARE PROVIDER: MARIYA VENGRENYUK M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1013367309
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 9638426372
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20200211002898
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name VENGRENYUK
Individual professional last name
Provider First Name MARIYA
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2016
Individual professional's medical school graduation year
Primary Specialty HOSPITALIST
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 INTERNAL MEDICINE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties INTERNAL MEDICINE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name APOGEE MEDICAL GROUP GEORGIA
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 4587676945
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 85
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 2501 N PATTERSON ST
Group Practice or individual's line 1 address
City VALDOSTA
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 316021735
Group Practice or individual's zip code (9 digits when available)
Phone Number 2293331000
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 390086
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 PENN HIGHLAND DUBOIS
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 110011
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 TANNER MEDICAL CENTER - CARROLLTON
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 080004
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 BAYHEALTH HOSPITAL, KENT CAMPUS
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 080009
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 BAYHEALTH - MILFORD MEMORIAL HOSPITAL
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 390027
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 TEMPLE UNIVERSITY HOSPITAL
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment M

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