Sergey Stepanov, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

N1462 Issued in TX

Practice address

14501 Montfort Dr
Apt #1502
Dallas, TX 75254-8546

Phone

(936) 931-8088

NPI assigned

Jun 5, 2008

Last updated

Jan 10, 2013By 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 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Internal Medicine

Education

University of Texas Southwestern Medical School at Dallas, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ess of Crockett, LLCGroup PAC ID 3678942778, 21 clinicians

Kayenta Alternative Rural HospitalGroup PAC ID 3678558129, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kayenta Alternative Rural Hospital Hospital, Kayenta, AZ, CCN 030195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Ess of Crockett, LLC

  • Emergency Medicine Physician
  • Crockett, TX
  • NPI 1649988635
  Medicare reassignment Care Compare group NPD
• Kayenta Alternative Rural Hospital

  • General Acute Care Hospital
  • Kayenta, AZ
  • NPI 1174692529

  TX

  Medicare reassignment Care Compare group NPD
• Ess of South Texas LLC

  • Emergency Medicine Physician
  • Liberty, TX
  • NPI 1295128247
  Medicare reassignment NPD
• Camp Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Pittsburg, TX
  • NPI 1902821515
  NPD (past)
• Cleveland Emergency Group PA

  • Emergency Medicine Physician
  • Cleveland, TX
  • NPI 1386604585
  NPD (past)
• Ellis Emergency Group PA

  • Emergency Medicine Physician
  • Ennis, TX
  • NPI 1497715239
  NPD (past)
• Rusk Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Henderson, TX
  • NPI 1891998126
  NPD (past)
• Kayenta Alternative Rural Hospital

  dba Inscription House Health Center

  • General Acute Care Hospital
  • Tonalea, AZ
  • NPI 1740359108
  NPD (past)
• Well Plus Medical PC

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1043250491
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357776000000",
    "number": "1336308113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14501 MONTFORT DR",
            "address_2": "APT #1502",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548546",
            "telephone_number": "936-931-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14501 MONTFORT DR",
            "address_2": "APT #1502",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548546",
            "telephone_number": "936-931-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPANOV",
        "first_name": "SERGEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2013-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N1462",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N1462",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "248715",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "N1462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steno Medical Supplies LLC
• Katherine Sanford Stensrud, APRN
• Jessica Stenzel
• Step by Step Anesthesia PLLC
• Step Med LLC
• Stepen M Tankersley MD
• Maria Stephan Laham, MD
• Stephanie H. Greenberg, PLLC
• Stephanie K. Teotia MD PA
• Stephanie L Atiyeh MD PA

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.