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

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Dr Vitaly Nazarov, MD is a medicare enrolled "Internal Medicine" physician in Kingsport, Tennessee. He graduated from medical school in 1989 and has 35 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Blue Ridge Medical Management Corporation, Blue Ridge Medical Management Corporation, Self Medical Group 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 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 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 Nazarov
GenderMale
SpecialityInternal Medicine
Experience35 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 Nazarov graduated from medical school in 1989
  NPI Data:
  • NPI Number: 1760469084
  • Provider Enumeration Date: 12/28/2005
  • Last Update Date: 07/06/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 9830114131
  • Enrollment ID: I20051005001193

Medical Identifiers

Medical identifiers for Dr Vitaly 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 40147 (Tennessee)Secondary
208M00000XHospitalist 0101254975 (Virginia)Secondary
207R00000XInternal Medicine 2017038349 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Greeneville Community HospitalGreeneville, TNHospital
Self Regional HealthcareGreenwood, SCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Blue Ridge Medical Management Corporation9739099441280
Blue Ridge Medical Management Corporation9739099441280
Self Medical Group6002953916326

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 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 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 Nazarov, MD
105 W Stone Dr, Suite 6a,
Kingsport, TN 37660-3365

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

Ph: (423) 224-3628

Reviews and Comments


Internal Medicine Doctors in Kingsport, TN

Annette Marie Abril, M.D.
Internal Medicine
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Practice Location: 3 Sheridan Sq, Kingsport, TN 37660
Phone: 423-392-6840    Fax: 423-392-6845
Rakeshkumar Bhagwandas Patel, M.D., MBA
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1025 Executive Park Blvd, Kingsport, TN 37660
Phone: 423-830-8110    Fax: 423-473-1102
Larry J Foster, M.D.
Internal Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 111 W Stone Dr, Suite 100, Kingsport, TN 37660
Phone: 423-247-5197    Fax: 423-247-5254
Dr. Adam Wesley Coe, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 135 W Ravine Rd, Suite 3a, Kingsport, TN 37660
Phone: 423-246-6777    Fax: 423-246-7766
Dr. Hetvi Kiritkumar Joshi, M.D.
Internal Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 130 W Ravine Rd, Kingsport, TN 37660
Phone: 423-224-3628    Fax: 423-230-8502
Dr. Kim Zahnke, M.D.
Internal Medicine
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
Internal Medicine
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.