Victa LLC
NPI 1104317007 · Addiction Medicine (Internal Medicine) Physician · Providence, RI
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Victa LLC is a Addiction Medicine (Internal Medicine) Physician organization in Providence, RI (NPI 1104317007).
Provider details
- NPI number
- 1104317007
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alexander Donoyan, Ceo(401) 300-5757
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Nursing Service Providers
- Peer Specialist175T00000X
Other Service Providers
- Counseling Psychologist103TC1900X
Behavioral Health & Social Service Providers
- Ambulatory Care Registered Nurse163WP2201X
Nursing Service Providers
- Mental Health Counselor101YM0800X
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
8 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
325 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Medication Assisted Treatment, Buprenorphine (oral); Weekly Bundle Including Dispensing And/Or Administration, Substance Use Counseling, Individual and Group Therapy, and Toxicology Testing If Performed (provision of the Services By a Medicare-Enrolled OpiG2068 | 325 | $283 |
Typical Medicare-allowed amounts for these services range $283–$283 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-05-25
- Last updated
- 2026-03-23
- Certified
- 2026-03-23
Frequently asked questions
- What is Victa LLC's NPI number?
- Victa LLC's National Provider Identifier (NPI) is 1104317007, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Victa LLC?
- Victa LLC is classified in the NPPES registry as Addiction Medicine (Internal Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Victa LLC located?
- Victa LLC's practice location on file with NPPES is 110 Elmwood Ave # a, Providence, RI 02907.
- What is Victa LLC's phone number?
- The practice phone number listed in the NPPES registry for Victa LLC is (401) 868-0654.
- Does Victa LLC accept Medicare?
- Victa LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Victa LLC?
- The authorized official listed on Victa LLC's NPPES record is Alexander Donoyan, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Victa LLC's NPI active?
- Yes — Victa LLC's NPI (1104317007) is active in the NPPES registry as of the last update on 2026-03-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.