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GREGORY AVETISOV DO
NPI 1679917280
General Practice in Lincoln, CA

Active since April 25, 2013PECOS Enrolled
2641 MILLER RUN LN, LINCOLN, CA 95648(209) 754-6262 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 1, 2026, Jan 28, 2026, Jan 6, 2025 and 1 more (4 updates tracked since 2020).

About Gregory Avetisov Do NPPES

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

GREGORY AVETISOV DO (NPI 1679917280) is an individual general practice provider in Lincoln, California, licensed in California (20A22510) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1679917280
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameGREGORY AVETISOVCredential: DO
Location Address2641 MILLER RUN LNLincoln, CA 95648-7545
Mailing AddressPo Box 939Angels Camp, CA 95222-0939
Phone(209) 754-6262
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateApril 25, 2013
Last NPPES UpdateJune 1, 20264 updates tracked since enumeration
NPPES CertifiedJune 1, 2026
✔ NPI 1679917280 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in CA · 20A22510
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X · License 17139 (FL)
2641 MILLER RUN LN, Lincoln, CA 95648
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gregory Avetisov Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335470400
PECOS Enrollment IDI20260108001909
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.

Medicare Billing Reassignments

10

Medicare enrollment records show Gregory Avetisov reassigns Medicare billing to 10 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lake County Tribal Health Southshore Clinic
73 mi
Federally Qualified Health Center (FQHC)
14440 OLYMPIC DRIVE
Clearlake, CA 95422
  • Reassigned Medicare billing, California enrollment
  • Medicare enrollment name: Lake County Tribal Health Consortium Inc
  • 59 clinicians in this Medicare group
NPI 1063158038 (707) 263-8382
Shane Speirs MD PC
443 mi
Multi-Specialty
35800 BOB HOPE DR STE 225
Rancho Mirage, CA 92270
  • Reassigned Medicare billing, California enrollment
  • 18 clinicians in this Medicare group
NPI 1750129672 (760) 673-7010
Newman Memorial Hospital, Inc
1,186 mi
Critical Access
905 S MAIN ST
Shattuck, OK 73858
  • Reassigned Medicare billing, Oklahoma enrollment
  • 20 clinicians in this Medicare group
NPI 1083617807 (580) 938-2551
Hospital Care Consultants, Inc
1,435 mi
Emergency Medicine
1 E CLARK BASS BLVD
Mcalester, OK 74501
  • Reassigned Medicare billing, Oklahoma enrollment
  • 82 clinicians in this Medicare group
NPI 1912945635 (918) 426-1800
Adair County Health Center,inc.
1,477 mi
Family Medicine
1401 W LOCUST ST, SUITE 102
Stilwell, OK 74960
  • Reassigned Medicare billing, Oklahoma enrollment
  • 49 clinicians in this Medicare group
NPI 1326017492 (918) 696-4065
Rural Health Care Incorporated
2,311 mi
Federally Qualified Health Center (FQHC)
100 COMMERCIAL DR
Keystone Heights, FL 32656
  • Reassigned Medicare billing, Florida enrollment
  • 76 clinicians in this Medicare group
NPI 1073589065 (352) 473-6595
Best Value Healthcare LLC
2,328 mi
Internal Medicine
1100 S FORT HARRISON AVE
Clearwater, FL 33756
  • Reassigned Medicare billing, Florida enrollment
  • 109 clinicians in this Medicare group
NPI 1790152015 (727) 223-3650
Florida Medical Specialists, LLC
2,329 mi
Internal Medicine
2128 MAIN ST
Dunedin, FL 34698
  • Reassigned Medicare billing, Florida enrollment
  • 186 clinicians in this Medicare group
NPI 1851056428 (727) 736-7733
Sunset Point Medical Associates Inc
2,329 mi
Internal Medicine
3820 TAMPA RD STE 202
Palm Harbor, FL 34684
  • Reassigned Medicare billing, Florida enrollment
  • 29 clinicians in this Medicare group
NPI 1366641698 (727) 785-4540
Vmd Primary Providers Central Florida PLLC
2,398 mi
Family Medicine
4501 13TH ST
Saint Cloud, FL 34769
  • Reassigned Medicare billing, Florida enrollment
  • 151 clinicians in this Medicare group
NPI 1134738974 (407) 798-8800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
30 services22 patients
Annual alcohol misuse screening, 5 to 15 minutes G0442
An annual alcohol misuse screening is a 15-minute check-up to assess your drinking habits. It helps identify if you're consuming alcohol in a way that could harm your health. This is not a judgment, but a tool to promote your wellbeing.
18 services18 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
16 services16 patients

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$62.99 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gregory Avetisov's NPI number?

The NPI number for Gregory Avetisov is 1679917280. It was assigned to this individual provider in the NPPES registry on April 25, 2013.

Where is Gregory Avetisov located?

Gregory Avetisov practices at 2641 Miller Run Ln, Lincoln, CA 95648. The listed phone number is (209) 754-6262.

What is Gregory Avetisov's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Gregory Avetisov enrolled in Medicare?

Yes. Gregory Avetisov is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Gregory Avetisov's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Avetisov reassigns Medicare benefits to 10 organizations: Lake County Tribal Health Southshore Clinic (Clearlake, CA), Shane Speirs MD PC (Rancho Mirage, CA), Newman Memorial Hospital, Inc (Shattuck, OK), Hospital Care Consultants, Inc (Mcalester, OK), Adair County Health Center,inc. (Stilwell, OK) and 5 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Gregory Avetisov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Gregory Avetisov was last updated on June 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.