Dr Vitaly Gennadievich Nazarov, MD - Medicare Internal Medicine in Kingsport, TN

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Dr Vitaly Gennadievich Nazarov, MD is a medicare enrolled "Internal Medicine" physician in Kingsport, Tennessee. He graduated from medical school in 1989 and has 37 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Blue Ridge Medical Management Corporation and his current practice location is 130 W Ravine Rd, Kingsport, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 224-3628.

Dr Vitaly Gennadievich Nazarov is licensed to practice in Missouri (license number 2017038349) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760469084.

Contact Information

Dr Vitaly Gennadievich Nazarov, MD
130 W Ravine Rd,
Kingsport, TN 37660-3837
(423) 224-3628
(423) 230-8502

Map and Direction




Physician's Profile

Full NameDr Vitaly Gennadievich Nazarov
GenderMale
SpecialityInternal Medicine
Experience37 Years
Location130 W Ravine Rd, Kingsport, Tennessee
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Vitaly Gennadievich Nazarov graduated from medical school in 1989
  NPI Data:
  • NPI Number: 1760469084
  • Provider Enumeration Date: 12/28/2005
  • Last Update Date: 11/21/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 9830114131
  • Enrollment ID: I20051005001193

Medical Identifiers

Medical identifiers for Dr Vitaly Gennadievich Nazarov such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1760469084NPI-NPPES
4122077OtherTNBCBST
TN0119OtherTNJOHN DEERE HEATLHCARE
3334533MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208M00000XHospitalist 0101254975 (Virginia)Secondary
208M00000XHospitalist 40147 (Tennessee)Secondary
207R00000XInternal Medicine 2017038349 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Greeneville Community HospitalGreeneville, TNHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Blue Ridge Medical Management Corporation9739099441306

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Vitaly Gennadievich Nazarov allows following entities to bill medicare on his behalf.
Entity NameSummit Medical Group, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659090298
PECOS PAC ID: 2860396330
Enrollment ID: O20031125000793
Entity NameBlue Ridge Medical Management Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144380833
PECOS PAC ID: 9739099441
Enrollment ID: O20031204000996
Entity NameBaptist Memorial Medical Group, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306089206
PECOS PAC ID: 5193610228
Enrollment ID: O20040218000385
Entity NameSoutheastern Physician Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1083835441
PECOS PAC ID: 0042307852
Enrollment ID: O20071025000571
Entity NameWellmont Medical Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780986257
PECOS PAC ID: 8123291739
Enrollment ID: O20111026000909

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Vitaly Gennadievich Nazarov is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Vitaly Gennadievich Nazarov, MD
105 W Stone Dr, Suite 6a,
Kingsport, TN 37660-3365

Ph: (423) 408-7220		Dr Vitaly Gennadievich Nazarov, MD
130 W Ravine Rd,
Kingsport, TN 37660-3837

Ph: (423) 224-3628

Reviews and Comments


Internal Medicine Doctors in Kingsport, TN

Dr. Swetha Paduri, MD
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Annette Marie Abril, M.D.
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Larry J Foster, M.D.
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Dr. Adam Wesley Coe, M.D.
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Phone: 423-246-6777    Fax: 423-246-7766
Dr. Hetvi Kiritkumar Joshi, M.D.
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Practice Location: 130 W Ravine Rd, Kingsport, TN 37660
Phone: 423-224-3628    Fax: 423-230-8502
Dr. Kim Zahnke, M.D.
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Medicare: May Accept Medicare Assignments
Practice Location: 2000 Brookside Dr, Third Floor, Kingsport, TN 37660
Phone: 423-857-5907    Fax: 423-857-5904
Dr. Dallas Shone, MD
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Medicare: Accepting Medicare Assignments
Practice Location: 105 W Stone Dr, Ste 4c, Kingsport, TN 37660
Phone: 423-578-1595    Fax: 423-392-6624

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.