GENNADIY VENGEROVICH – Otolaryngology Physician, NPI 1477708907

GENNADIY VENGEROVICH is a healthcare provider. based in Los angeles, California. specializing in OTOLARYNGOLOGY. They hold a License No. ME116592 (FL). The NPI Number for GENNADIY VENGEROVICH is 1477708907

Main info

Male
20 Years Of Experience
Accepts Medicare Assignment
Name
GENNADIY VENGEROVICH
NPI
1477708907
Phone
(646) 243-8934
Address
5767 W CENTURY BLVD STE 400
Enumeration Date
25 November 2008
Last Update Date
18 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5617368141
Graduation Year
2006 (20 years ago)
PAC ID
7810167327
Group Practice PAC ID
4587556923
Professional Enrollment ID
I20131024000878
Address ID
FL334373776BO10150RDXX401
Telehealth
Yes

Contacts

Secure Messaging
gennadiy.vengerovich.1@20937.direct.athenahealth.com
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness85
Years active:17State licenses:1Other namesUpdated within 12 months

1,359 OTOLARYNGOLOGY in CA

Provider Addresses for GENNADIY VENGEROVICH

  • 5767 W CENTURY BLVD STE 400

    LOS ANGELES, CA 900455631

    Phone: (646) 243-8934

    Type: Mailing

  • 200 UCLA MEDICAL PLZ STE 550

    LOS ANGELES, CA 90095

    Phone: (310) 203-6688

    Type: Location

  • 10150 HAGEN RANCH RD STE 100

    BOYNTON BEACH, FL 334373776

    Phone: (561) 736-8141

    Type: Mailing

  • 15280 NW 79TH CT STE 200

    MIAMI LAKES, FL 330165873

    Phone: (305) 558-3724

    Fax: (786) 907-4485

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 8 Open Payments records for all available years, with a total value of $738.

Total Amount is formed as General ($738) + Research ($0) + Ownership ($0) = $738.

Last reported payment date: 2024-10-08 • Largest payer in this snapshot: Stryker Corporation ($377).

Total Amount

$738

General + Research + Ownership

Payments

8

Total payment records

General Amount

$738

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-08

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-10-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20131024000878IOtolaryngologyFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes547357$0
99203New patient office or other outpatient visit, 30-44 minutes301301$0
31231Diagnostic exam of nasal passages using an endoscope300215$0
92557Comprehensive hearing and speech recognition test224195$0
92567Test to assess middle ear function218193$0
View full utilization report →

Insurance plans in this area (ZIP 90045)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587556923View full group profile
NameSpecialtyState
-FL
O T O L A R Y N G O L O G YFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL
Qualified AudiologistFL
Qualified AudiologistFL
O T O L A R Y N G O L O G YFL

Reviews

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Frequently asked questions

Is GENNADIY VENGEROVICH listed with a National Provider Identifier?
Yes — GENNADIY VENGEROVICH has NPI 1477708907 on file in the registry.
Is there an active status for GENNADIY VENGEROVICH?
For scheduling context, GENNADIY VENGEROVICH is shown as active in the registry.
What area of care is associated with GENNADIY VENGEROVICH?
GENNADIY VENGEROVICH's record emphasizes Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Is GENNADIY VENGEROVICH located near Los Angeles?
GENNADIY VENGEROVICH currently maps to Los Angeles, California in this extract.
When was this NPI issued?
Enumeration for GENNADIY VENGEROVICH is noted as November 25, 2008 where the registry provides it.

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