Individual provider Active NPI

Sergei Ivantchev, M.D

  • Family Medicine Physician
  • Washington, DC
National Provider Identifier
1366416356
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD38969 Issued in SC
Practice address
2401 E St NW
Suite L209
Washington, DC 20037
Phone
(202) 663-1542
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 14527 HI
Family Medicine Physician 207Q00000X 238526 MA
Family Medicine Physician 207Q00000X MD38969 SC Primary

Addresses

Primary practice location

2401 E St NW
Suite L209
Washington, DC 20037

Mailing address

2401 E St NW Suite L209
Washington, DC 20037
Phone (202) 633-1718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091124000476 MA Practitioner - Emergency MedicinePractitioner - Family Practice 6800868134
I20160217002081 SC Practitioner - Emergency MedicinePractitioner - Family Practice 6800868134 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14527HIMDFamily Medicine Physician
MD38969SCMDFamily Medicine Physician
002551CTMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Family Medicine CurrentSince Jun 11, 2020 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 25, 2016 Accepting new patients
Musc Community Physicians Current Accepting new patients
Edcare Consulting LLC CurrentSince Dec 3, 2022 Accepting new patients
Musc Community Physicians Family Medicine CurrentSince Jan 16, 2024 Accepting new patients
Musc Community Physicians CurrentSince Jan 16, 2024 Accepting new patients
Carolina Family Care, Inc Family Medicine CurrentSince Jun 11, 2020 Accepting new patients
App of South Carolina Ed PLLC CurrentSince Oct 31, 2017 Accepting new patients
Spartanburg Medical Center CurrentSince Jan 25, 2016 Accepting new patients
Umass Memorial Medical Group Inc Family Medicine Past Accepting new patients
Baystate Affiliated Practice Organization Family Medicine Past Accepting new patients
Baystate Medical Practices, Inc Past Accepting new patients

Locations

420 Thomson Cir
Abbeville, SC 29620
Phone (864) 366-1649

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1304 W Bobo Newsom Hwy
Hartsville, SC 29550
Phone (469) 340-1366

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1366416356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 E ST NW SUITE L209",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20037",
            "telephone_number": "202-633-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 E ST NW",
            "address_2": "SUITE L209",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20037",
            "telephone_number": "202-663-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANTCHEV",
        "first_name": "SERGEI",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "HI",
            "license": "14527",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "238526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MD38969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.