Individual provider Active NPI

Sergey Grachev, M.D.

  • Surgery Physician
  • Manahawkin, NJ
National Provider Identifier
1487629614
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
25MA07937200 Issued in NJ
Practice address
115 E Bay Ave
Manahawkin, NJ 08050-3109
Phone
(609) 597-9477
Fax
(609) 597-9877
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA07937200 NJ Primary

Addresses

Primary practice location

115 E Bay Ave
Manahawkin, NJ 08050-3109

Mailing address

PO Box 367
Manahawkin, NJ 08050-0367
Phone (609) 597-9477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20060111000716 NJ Practitioner - General Surgery 1658398490 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 E Bay Ave
Manahawkin, NJ 08050-3109
Phone (609) 597-9477

Hospital & facility affiliations

  • Southern Ocean Medical Center Hospital, Manahawkin, NJ, CCN 310113
  • Community Medical Center Hospital, Toms River, NJ, CCN 310041
  • Centrastate Medical Center Hospital, Freehold, NJ, CCN 310111
  • Monmouth Medical Center-Southern Campus Hospital, Lakewood, NJ, CCN 310084
  • Ocean Medical Center Hospital, Brick, NJ, CCN 310052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)14
Hernia repair (minimally invasive)21
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Ocean County Surgical Association, LLC Surgery CurrentSince Aug 6, 2005 Accepting new patients
Hospital Group of South Jersey, PC Past Accepting new patients

Locations

44 Nautilus Dr
Ste 2B
Manahawkin, NJ 08050
Phone (609) 489-0222

115 E Bay Ave
Manahawkin, NJ 08050
Phone (609) 597-9477

Interoperability endpoints

  • Direct secure messaging: segey.grachev@southernoceancountysurgicalasso.chartmakerdirect.com
  • Direct secure messaging: sgrachev425153@direct.ahsys.org

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1487629614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 367",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080500367",
            "telephone_number": "609-597-9477",
            "fax_number": "609-597-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E BAY AVE",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503109",
            "telephone_number": "609-597-9477",
            "fax_number": "609-597-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACHEV",
        "first_name": "SERGEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA07937200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manahawkin, NJ

Sources for this page

Verify at the official NPI Registry.