Sergei Veniaminovich Dmitruk, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

54890 Issued in KY

Practice address

4010 Dupont Cir Ste 380
Louisville, KY 40207-4881

Phone

(502) 895-0040

Fax

(502) 214-3429

NPI assigned

Apr 12, 2017

Last updated

Oct 17, 2024By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Ophthalmology

Education

University of Colorado School of Medicine, Aurora, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Centers of Louisville,PSCGroup PAC ID 4789584921, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carroll County Memorial Hospital Hospital, Carrollton, KY, CCN 181310

Merit-based Incentive Payment System (MIPS)

Final score

86.51 of 100Reported as group

Quality

84.13

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: sdmitruk@bennettbloomeyecenters.imwdirect.com
• Direct secure messaging: sergei.dmitruk.p2@direct.johnkenyon.nextgenshare.com

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.

• Eye Centers of Louisville,PSC

  dba Bennett & Bloom Eye Centers

  • Ophthalmology Physician
  • Louisville, KY
  • NPI 1659385508

  IN

  Medicare reassignment Care Compare group NPD
• John Kenyon American Eye Institute LLC

  • Ophthalmology Physician
  • New Albany, IN
  • NPI 1447259510

  KY

  Medicare reassignment NPD
• Eye Centers of Louisville,P.S.C.

  dba Bluegrass Surgery & Laser Center

  • Ambulatory Surgical Clinic/Center
  • Louisville, KY
  • NPI 1396763074
  NPD
• John Kenyon American Eye Institute LLC

  dba Eye Surgery Center of Elizabethtown

  • Ambulatory Surgical Clinic/Center
  • Elizabethtown, KY
  • NPI 1013513308
  NPD

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

• CCMH Corporation

  dba Carroll County Memorial Hospital

  • Critical Access Hospital
  • Carrollton, KY
  • NPI 1225159601
  Care Compare affiliation

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1184158602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 BLUEGRASS AVE STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151181",
            "telephone_number": "502-364-0033",
            "fax_number": "502-361-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE 380",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074881",
            "telephone_number": "502-895-0040",
            "fax_number": "502-214-3429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Johnstown Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427013925",
            "country_code": "US",
            "telephone_number": "270-769-0099",
            "fax_number": "270-763-0315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 11th St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "KY",
            "postal_code": "410081435",
            "country_code": "US",
            "telephone_number": "800-477-0055",
            "fax_number": "502-361-4488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "519 State St",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471503620",
            "country_code": "US",
            "telephone_number": "812-948-0616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9200 Leesgate Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402225173",
            "country_code": "US",
            "telephone_number": "502-895-2910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Quartermaster Ct",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471303623",
            "country_code": "US",
            "telephone_number": "812-284-0077",
            "fax_number": "812-284-0129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DMITRUK",
        "first_name": "SERGEI",
        "middle_name": "VENIAMINOVICH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01085592A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "54890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300050894",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100740700",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mladen Djurasovic, MD
• DK Gopinath MD PSC (Gopinath & Alankar MD PSC)
• DLS Medical Associates, LLC
• DME
• Dmhdmd Inc
• DMMD Concierge LLC
• DO Medical Consulting
• DO Not Use
• DO Not Use
• DO Not Use

• Ophthalmology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Ophthalmology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.