Gerald S Sevachko, M..D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35031136 Issued in OH

Practice address

8135 Market St
Youngstown, OH 44512-6244

Phone

(330) 758-0900

Fax

(330) 758-2790

NPI assigned

Jul 13, 2005

Reactivated

Mar 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• G. S. Optical, Inc.

  • Eyewear Supplier
  • Youngstown, OH
  • NPI 1629186861
  NPD (past) Authorized official

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1477551349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8135 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126244",
            "telephone_number": "330-758-0900",
            "fax_number": "330-758-2790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 MARKET ST",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126244",
            "telephone_number": "330-758-0900",
            "fax_number": "330-758-2790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVACHKO",
        "first_name": "GERALD",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M..D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2014-07-01",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "35031136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0154309",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serenity Sisters Homecare LLC
• Kristinn Marie Sergi, CRNA
• Serhat Erzurum MD
• Julie Serrano, CRNA
• Madison M Settle, RN
• Sevana Behavioral Healthcare
• Aiden Sexton
• Renee Sferra, CNS
• Jessyka Marie Shackelford
• Stephen I Shackelford

• All providers in Youngstown, OH
• Ophthalmology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; 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.