NPIMap

Organization Active NPI

Serge Lartchenko M.D., PLLC

  • General Acute Care Hospital
  • Dallas, TX
National Provider Identifier
1508199621
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
M8115 Issued in TX
Legal business name
SERGE LARTCHENKO M.D., PLLC
Practice address
2320 Hugo St
#1901
Dallas, TX 75204-2801
Phone
(214) 300-1364
Fax
(214) 295-6866
NPI assigned
Sep 8, 2009
Last updated
Sep 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Authorized official

Name
Dr. Serge Lartchenko, M.D.NPI 1992787089
Title
Member
Phone
(214) 300-1364

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X M8115 TX Primary

Addresses

Primary practice location

2320 Hugo St
#1901
Dallas, TX 75204-2801

Mailing address

2320 Hugo St
#1901
Dallas, TX 75204-2801
Phone (214) 300-1364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100105000773 TX Part B Supplier - Clinic/Group Practice 1850432311 Receives reassigned benefits from 15 practitioners
Practice locations: Dallas, TX; Richardson, TX; Mesquite, TX; Desoto, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252368000000",
    "number": "1508199621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 HUGO ST",
            "address_2": "#1901",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042801",
            "telephone_number": "214-300-1364",
            "fax_number": "214-295-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 HUGO ST",
            "address_2": "#1901",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042801",
            "telephone_number": "214-300-1364",
            "fax_number": "214-295-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGE LARTCHENKO M.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-08",
        "last_updated": "2009-09-08",
        "status": "A",
        "authorized_official_last_name": "LARTCHENKO",
        "authorized_official_first_name": "SERGE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-300-1364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "TX",
            "license": "M8115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.