Sergey Vladlenovich Veretennikov

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A180890 Issued in CA

Practice address

7248 S Land Park Dr Ste 205
Sacramento, CA 95831-3661

Phone

(916) 371-4939

Fax

(916) 392-2722

NPI assigned

Jul 3, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Garcia Lee and Concepcion Medical Group IncGroup PAC ID 2769473735, 9 clinicians

Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy General Hospital Hospital, Sacramento, CA, CCN 050017
• Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108
• Sutter Roseville Medical Center Hospital, Roseville, CA, CCN 050309

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sveretennikov238965@hpmg.direct-ci.net
• Direct secure messaging: sergey.veretennikov.1@18067.direct.athenahealth.com

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.

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Sacramento, CA
  • NPI 1700803418
  Medicare reassignment Care Compare group NPD
• Garcia Lee and Concepcion Medical Group Inc

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1417020579
  Medicare reassignment Care Compare group NPD
• Sutter Valley Medical Foundation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1669846986
  Medicare reassignment Care Compare group
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432
  NPD
• Garcia, Lee & Concepcion Medical Group

  • Family Medicine Physician
  • West Sacramento, CA
  • NPI 1639368079
  NPD
• Dignity Community Care

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1467560599
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  NPD (past)
• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Rancho Cordova, CA
  • NPI 1568489268
  NPD (past)
• Hill Physicians Medical Group - PPO Program

  • Preferred Provider Organization
  • San Ramon, CA
  • NPI 1679011035
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1487694857
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Roseville, CA
  • NPI 1356390264
  Care Compare affiliation
• Sutter Valley Hospitals

  • General Acute Care Hospital
  • Sacramento, CA
  • NPI 1811946734
  Care Compare affiliation

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1134640899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7248 S LAND PARK DR STE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313661",
            "telephone_number": "916-371-4939",
            "fax_number": "916-392-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7248 S LAND PARK DR STE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313661",
            "telephone_number": "916-371-4939",
            "fax_number": "916-392-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERETENNIKOV",
        "first_name": "SERGEY",
        "middle_name": "VLADLENOVICH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A180890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Cheree Vercruyssen
• Claudia Verduzco Vallery, RESPIRATORY THERAPIS
• Mauricio Esteban Verduzco, ASW
• Maya Verduzco
• Stephanie Verduzco
• Kendra Verga
• Brenda Vergara
• Annie Kannenpla Verghese
• Summer Joy Verhines, LCSW
• Louis S Verhoeven Sr.

• Family Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.