Active NPI
Oleg V Serbine, M.D.
- Pain Medicine (Anesthesiology) Physician
- Fort Mohave, AZ
National Provider Identifier
1285649145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- 37626
- Practice address
- 1510 E Wagon Wheel LN
Ste. 110
Fort Mohave, AZ 86426-6697 - Phone
- (928) 788-3333
- Fax
- (928) 788-3555
- NPI assigned
- Jul 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 37626 | AZ | Primary |
| Anesthesiology Physician | 207L00000X | 37626 | AZ |
Addresses
Primary practice location
1510 E Wagon Wheel LN
Ste. 110
Fort Mohave, AZ 86426-6697
Mailing address
PO Box 10966
Fort Mohave, AZ 86427-0966
Phone (928) 788-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 103360 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Verde Valley Medical Center | Past | Accepting new patients | |
| Medstat Anesthesia Consultants | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Fort Mohave, AZ
- NPI 1962573436
-
- General Acute Care Hospital
- Cottonwood, AZ
- NPI 1346291648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1285649145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10966",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864270966",
"telephone_number": "928-788-3333",
"fax_number": "928-788-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 E WAGON WHEEL LN",
"address_2": "STE. 110",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864266697",
"telephone_number": "928-788-3333",
"fax_number": "928-788-3555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERBINE",
"first_name": "OLEG",
"middle_name": "V",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-29",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "AZ",
"license": "37626",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AZ",
"license": "37626",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103360",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Mohave, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.