Sergey Sergeyevich Progushev MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

SERGEY SERGEYEVICH PROGUSHEV MD INC

Practice address

18330 Roscoe Blvd
Northridge, CA 91325-4105

Phone

(747) 224-4004

NPI assigned

Nov 8, 2024

Organization subpart

No

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

Authorized official

Name

Sergey Sergeyevich Progushev, MDNPI 1285193342

Title

President

Phone

(912) 658-1150

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sergey Sergeyevich Progushev, MD

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1285193342
  NPD Authorized official

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

{
    "created_epoch": "1731024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1265256176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "686 MONTEREY PL",
            "city": "SIERRA MADRE",
            "state": "CA",
            "postal_code": "910242105",
            "telephone_number": "912-658-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18330 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254105",
            "telephone_number": "747-224-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGEY SERGEYEVICH PROGUSHEV MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-08",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "PROGUSHEV",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_middle_name": "SERGEYEVICH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-658-1150",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.