OLEG LOGVINOVICH KIBUKEVICH MD
NPI 1407559610
Student in an Organized Health Care Education/Training Program in Towson, MD

Active since March 24, 2023PECOS Enrolled
6565 N CHARLES ST STE 203, TOWSON, MD 21204(443) 849-3760 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Oleg Logvinovich Kibukevich Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OLEG LOGVINOVICH KIBUKEVICH MD (NPI 1407559610) is an individual student in an organized health care education/training program in Towson, Maryland and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and maintains a secondary practice location in Rochester.

NPPES Registry Identity

NPI1407559610
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameOLEG LOGVINOVICH KIBUKEVICHCredential: MD
Location Address6565 N CHARLES ST STE 203Towson, MD 21204-5805
Mailing Address4161 Dewey AveRochester, NY 14616-1214
Sole ProprietorNo
Enumeration DateMarch 24, 2023
Last NPPES UpdateFebruary 24, 2026
NPPES CertifiedFebruary 24, 2026
NPI 1407559610 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

6565 N CHARLES ST STE 203, Towson, MD 21204

Secondary Practice Location 1

Location 11425 Portland Ave Bldg 3Rochester, NY 14621-3095 · Phone (585) 922-4000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Oleg Logvinovich Kibukevich Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Internal Medicine
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Student in an Organized Health Care Education/Training Program
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Student in an Organized Health Care Education/Training Program
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Internal Medicine
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Radiology (Radiation Oncology)
6565 N CHARLES ST STE 203
BALTIMORE, MD 21204
Student in an Organized Health Care Education/Training Program
6565 N CHARLES ST STE 203
TOWSON, MD 21204
Student in an Organized Health Care Education/Training Program
6565 N CHARLES ST STE 203
TOWSON, MD 21204

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1407559610, enumerated as an "individual" on March 24, 2023.

The provider is located at 6565 N CHARLES ST STE 203 TOWSON, MD 21204 and the phone number is (443) 849-3760.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.