Gerald S. Sevachko, M.D., Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35031136 Issued in OH

Legal business name

GERALD S. SEVACHKO, M.D., INC.

Practice address

7422 Southern Blvd
Youngstown, OH 44512-5629

Phone

(330) 758-3937

Fax

(330) 758-4956

NPI assigned

Aug 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gerald S Sevachko, M.D.

Title

Owner/President

Phone

(330) 758-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1265540447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7422 SOUTHERN BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125629",
            "telephone_number": "330-758-3937",
            "fax_number": "330-758-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7422 SOUTHERN BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125629",
            "telephone_number": "330-758-3937",
            "fax_number": "330-758-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD S. SEVACHKO, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "SEVACHKO",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "330-758-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35031136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154309",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.