Individual provider Active NPI

Sergey Zhitnikov, MD

  • Surgery Physician
  • Chester, PA
National Provider Identifier
1083640478
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD450442 Issued in PA
Practice address
1 Medical Center Blvd
Acp 11, Suite 326
Chester, PA 19013-3902
Phone
(610) 619-8450
Fax
(610) 619-8451
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 044063 CT
Surgery Physician 208600000X MD450442 PA Primary

Addresses

Primary practice location

1 Medical Center Blvd
Acp 11, Suite 326
Chester, PA 19013-3902

Mailing address

One Medical Center Blvd
Pob 11, Suite 326
Upland, PA 19013-3901
Phone (610) 619-8450

Other practice location 1

120 N 7th St Ste 200
Chambersburg, PA 17201-1795
Phone (717) 217-6800

Other practice location 2

450 S Washington St Fl 3
Gettysburg, PA 17325-2500
Phone (717) 339-3110

Other identifiers 6

IdentifierTypeStateIssuer
2V7418OtherCTHEALTH NET
560H71OtherCTEMPIRE BC/BS
044063OtherCTCONNECTICARE
7370741OtherCTAETNA - PPO
9386052OtherCTCIGNA
1207285OtherCTAETNA - HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20140130000671 PA Practitioner - General Surgery 3072523299 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Apr 8, 2024 Accepting new patients
Prospect Health Access Network, Inc. Surgery CurrentSince Jul 1, 2016 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Prospect Health Access Network, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Prospect Health Access Network, Inc. Current Accepting new patients
Wellspan Medical Group CurrentSince Apr 8, 2024 Accepting new patients
Saint Raphael Faculty Physicians Surgery Past Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Surgery Past Accepting new patients
Prospect Health Access Network, Inc. Past Accepting new patients

Locations

120 N 7th St
Ste 200
Chambersburg, PA 17201
Phone (717) 217-6800

1 Medical Center Blvd
Ste 301
Chester, PA 19013
Phone (610) 566-6744

1 Medical Center Blvd
Chester, PA 19013
Phone (610) 447-6666

1 Medical Center Blvd
Ste 326
Chester, PA 19013
Phone (610) 619-8450

1 Medical Center Blvd
Ste 233
Chester, PA 19013
Phone (610) 499-0400

450 S Washington St
Ste C
Gettysburg, PA 17325
Phone (717) 334-8141

450 S Washington St
Fl 3
Gettysburg, PA 17325
Phone (717) 339-3110

500 Evergreen Dr
Ste 23
Glen Mills, PA 19342
Phone (610) 579-3630

100 W Sproul Rd
Ste 123
Springfield, PA 19064
Phone (610) 619-8281

1600 S George St
York, PA 17403
Phone (717) 848-3615

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742342400000",
    "number": "1083640478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE MEDICAL CENTER BLVD",
            "address_2": "POB 11, SUITE 326",
            "city": "UPLAND",
            "state": "PA",
            "postal_code": "190133901",
            "telephone_number": "610-619-8450",
            "fax_number": "610-619-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "address_2": "ACP 11, SUITE 326",
            "city": "CHESTER",
            "state": "PA",
            "postal_code": "190133902",
            "telephone_number": "610-619-8450",
            "fax_number": "610-619-8451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 N 7th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011795",
            "country_code": "US",
            "telephone_number": "717-217-6800",
            "fax_number": "717-839-2807",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 S Washington St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252500",
            "country_code": "US",
            "telephone_number": "717-339-3110",
            "fax_number": "717-339-3108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZHITNIKOV",
        "first_name": "SERGEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "044063",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD450442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "2V7418",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC/BS",
            "identifier": "560H71",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "044063",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "7370741",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9386052",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "1207285",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, PA

Sources for this page

Verify at the official NPI Registry.