Eric Michael Sergienko, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

A55033 Issued in CA

Practice address

250 Vandenberg St
US Northern Command Surgeon's Office
Colorado Springs, CO 80914-3898

Phone

(703) 554-0042

Fax

(703) 554-7227

NPI assigned

Jul 10, 2008

Last updated

Jul 10, 2008By 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 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Erx Hospitalist Group PC

  • Hospitalist Physician
  • Knoxville, TN
  • NPI 1699199562

  CA

  Medicare reassignment NPD
• Erx Plus Professional Corporation

  • Emergency Medicine Physician
  • Mariposa, CA
  • NPI 1336508407
  Medicare reassignment NPD
• Central California Radiology Associates Inc

  • Diagnostic Radiology Physician
  • Visalia, CA
  • NPI 1619343050
  NPD (past)
• Erx Plus Professional Corporation

  • Emergency Medicine Physician
  • Sun Valley, CA
  • NPI 1003681693
  NPD (past)
• Sierra Rural Physicians, Inc.

  • Emergency Medicine Physician
  • Mariposa, CA
  • NPI 1699890905
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1255595179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 VANDENBERG ST",
            "address_2": "US NORTHERN COMMAND SURGEON'S OFFICE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809143898",
            "telephone_number": "703-554-0042",
            "fax_number": "703-554-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 VANDENBERG ST",
            "address_2": "US NORTHERN COMMAND SURGEON'S OFFICE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809143898",
            "telephone_number": "703-554-0042",
            "fax_number": "703-554-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGIENKO",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A55033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Peaks Recovery Center
• Serenity Peaks Recovery Center LLC
• Serenity Psychotherapy, LLC
• Serenity Transportation Inc
• Kendra Sereno
• Demetra Seriki, CNM
• Linda Sue Serkman, MT
• Clarissa Serna, RBT
• Marissa Serna
• Nayeli Serna

• Emergency Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Emergency Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.