| Dr Irina Goncharova, MD | |
|
2801 W Kinnickinnic River Pkwy, Suite 485, Milwaukee, WI 53215-3669 | |
| (414) 646-8900 | |
| Not Available |
| Full Name | Dr Irina Goncharova |
|---|---|
| Gender | Female |
| Speciality | Vascular Surgery |
| Experience | 26 Years |
| Location | 2801 W Kinnickinnic River Pkwy, Milwaukee, Wisconsin |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104857465 | NPI | - | NPPES |
| 34885400 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 03611663 (Illinois) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 49279 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Javon Bea Hospital | Rockford, IL | Hospital |
| Mercy Health System Corp | Janesville, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rockford Health Physicians | 2567374036 | 362 |
| Entity Name | Rockford Health Physicians |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043242886 PECOS PAC ID: 2567374036 Enrollment ID: O20031103000584 |
| Entity Name | Mercy Health System Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598718603 PECOS PAC ID: 7416860440 Enrollment ID: O20031111000307 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Irina Goncharova, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Dr Irina Goncharova, MD 2801 W Kinnickinnic River Pkwy, Suite 485, Milwaukee, WI 53215-3669 Ph: (414) 646-8900 |
Jiro Kimura, Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-6400 Fax: 414-955-0213 | |
Dr. David L Larson, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 8700 Watertown Plank Road, Wisconsin Athletic Club Bldg, Milwaukee, WI 53226 Phone: 414-805-3666 | |
Dr. John J Aiken, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
Jeffrey Anderson, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 215-707-3133 | |
Dr. Jeremy Holzmacher Levin, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-955-1700 Fax: 414-955-0072 | |
Dr. Keith T Oldham, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
William R Deshur, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2801 W Kk River Pkwy, Suite 330, Milwaukee, WI 53215 Phone: 414-649-3240 Fax: 414-649-3244 |