Serge N Kolev, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD064859Y Issued in PA

Practice address

1300 Bent Creek Blvd
Suite 202
Mechanicsburg, PA 17050-1871

Phone

(717) 458-8401

Fax

(717) 458-8403

NPI assigned

Dec 13, 2005

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

Other identifiers 3

Other names 1

• Dr. Serge N Kolev Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Medical and Cosmetic Dermatology, LLC

  • Dermatology Physician
  • Mechanicsburg, PA
  • NPI 1275792582
  NPD Authorized official

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1144205030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BENT CREEK BLVD",
            "address_2": "SUITE 202",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170501871",
            "telephone_number": "717-458-8401",
            "fax_number": "717-458-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BENT CREEK BLVD",
            "address_2": "SUITE 202",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170501871",
            "telephone_number": "717-458-8401",
            "fax_number": "717-458-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLEV",
        "first_name": "SERGE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD064859Y",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0016961160002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "354924",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "50000718",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERGE",
            "last_name": "KOLEV",
            "middle_name": "N",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Noah Klinger
• Jennifer Leigh Kneppar, M.D.
• Michele M Knepper, CRNP
• Caryn Knott
• John Constantine Kokos, DPT
• Nithya Sailakshmi Kolluri, DMD
• Saketram Komanduri, MD
• Jordan Bull Korge
• Pauline Hricisak Kostelac, DO
• Sarah Emily Koury, DMD

• Dermatology Physician in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.