Individual provider Active NPI

Serguei Ivanovich Bannykh, MD

  • Anatomic Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1053392365
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
A72353 Issued in CA
Practice address
8700 Beverly Blvd
Suite 8730
Los Angeles, CA 90048
Phone
(310) 423-3562
Fax
(310) 423-0122
NPI assigned
Nov 14, 2005
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neuropathology Physician 207ZN0500X 040897 CT
Anatomic Pathology Physician 207ZP0101X 040897 CT
Anatomic Pathology Physician 207ZP0101X A72353 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd
Suite 8730
Los Angeles, CA 90048

Mailing address

8700 Beverly Blvd
Suite 8730
Los Angeles, CA 90048
Phone (310) 423-3562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070110000400 CA Practitioner - Pathology 7911907274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cedars-Sinai Medical Care FoundationGroup PAC ID 0941106645, 1,684 clinicians

Practice addresses (Care Compare)

8635 W 3Rd St
Suite 465W
Los Angeles, CA 90048-6111
Phone (310) 423-0674

8700 Beverly Blvd
West Hollywood, CA 90048-1804
Phone (310) 423-1447

8723 Alden Dr
Suite 260
Los Angeles, CA 90048-1804
Phone (310) 248-8299

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
84.79
Promoting interoperability
99
Improvement activities
40
Cost
73.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A72353CAMDAnatomic Pathology Physician
040897CTMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Care Foundation CurrentSince Jan 1, 2015 Accepting new patients
CPLM Pathology Outreach Services Anatomic Pathology Past Accepting new patients
Consultants for Path & Lab Med Inc, a Medical Group PastSince Jul 1, 2011 Accepting new patients

Locations

8635 W 3rd St
Ste 465W
Los Angeles, CA 90048
Phone (310) 423-0674

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

8700 Beverly Blvd
Rm 8725
West Hollywood, CA 90048
Phone (310) 423-6627

8700 Beverly Blvd
Ste 8730
West Hollywood, CA 90048
Phone (310) 423-3562

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1053392365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "SUITE 8730",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-423-3562",
            "fax_number": "310-423-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD",
            "address_2": "SUITE 8730",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-423-3562",
            "fax_number": "310-423-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANNYKH",
        "first_name": "SERGUEI",
        "middle_name": "IVANOVICH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "CT",
            "license": "040897",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CT",
            "license": "040897",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A72353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.