Sergey L Istomin, CRNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R208690 Issued in MD

Practice address

6040 Southport Dr
Bethesda, MD 20814-1848

Phone

(301) 493-4200

NPI assigned

Mar 26, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chase Brexton Health Services, Inc.

  dba Chase Brexton Health Care

  • Federally Qualified Health Center (FQHC)
  • Baltimore, MD
  • NPI 1588606305
  Medicare reassignment NPD
• Cornerstone Montgomery, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bethesda, MD
  • NPI 1194725739

  DC

  Medicare reassignment NPD
• Chase Brexton Health Services, Inc.

  dba Chase Brexton Health Care

  • Federally Qualified Health Center (FQHC)
  • Columbia, MD
  • NPI 1376589309
  NPD
• Cornerstone Montgomery, Inc.

  • Adult Mental Health Clinic/Center
  • Silver Spring, MD
  • NPI 1174995781
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1023384963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 SOUTHPORT DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141848",
            "telephone_number": "301-493-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 SOUTHPORT DR",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141848",
            "telephone_number": "301-493-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISTOMIN",
        "first_name": "SERGEY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-26",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R208690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kazusa Ishii, M.D.
• Ishtiaq a Malik, MD PC
• Adeya M Ison
• Ispar Foundation, Inc.
• Issa Physical Therapy & Wellness, LLC.
• Ithrive Health (Village Green Apothecary)
• Ithrive Health (village green apothecary)
• Christopher Yuki Itoh, MD, MHS
• Luis Iturriaga, PH.D.
• Yuliya Ivanilova, LMT

• Psychiatric/Mental Health Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.