Active NPI
Sergey Golovko, MD
- Psychiatry Physician
- Liverpool, NY
National Provider Identifier
1497176333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD463679
- Practice address
- 125 Sun Harbor Dr
Liverpool, NY 13088 - Phone
- (315) 453-5508
- NPI assigned
- Dec 19, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD463679 | PA | Primary |
Addresses
Primary practice location
125 Sun Harbor Dr
Liverpool, NY 13088
Mailing address
125 Sun Harbor Dr
Liverpool, NY 13088-4323
Phone (315) 765-3250
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240708003914 | NY | Order and Referring Only - Psychiatry | 3375893498 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD463679 | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1387411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528416000000",
"number": "1497176333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 SUN HARBOR DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130884323",
"telephone_number": "315-765-3250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 SUN HARBOR DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "13088",
"telephone_number": "315-453-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLOVKO",
"first_name": "SERGEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-19",
"last_updated": "2018-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD463679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.