Sergei N Petrochko, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

005330 Issued in NY

Practice address

17 Main Street
Binghamton, NY 13905

Phone

(607) 723-8354

Fax

(607) 723-9017

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empire Vision Center Inc

  • Optometrist
  • Syracuse, NY
  • NPI 1750358826
  Medicare reassignment NPD
• Empire Vision Center, Inc

  • Eyewear Supplier
  • Attleboro, MA
  • NPI 1730635582
  NPD
• Binghamton Optical Inc

  • Eyewear Supplier
  • Binghamton, NY
  • NPI 1922116854
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1538239470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 VALLEYVIEW DRIVE",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137602550",
            "telephone_number": "607-786-3741",
            "fax_number": "607-786-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MAIN STREET",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-723-8354",
            "fax_number": "607-723-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCHKO",
        "first_name": "SERGEI",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "005330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01482897",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carlee Peterson, FNP
• Katrina Peterson, PT
• Roberta Kuhns Peterson, S.L.P.
• Rebecca Lynn Petrigala, LCSW
• Karolina Petro, M.D.
• Rayford A Petroski, MD
• Thomas M. Phalen
• Sean Phelan
• Natalie Phelps, LMSW
• Robert C Philips, DPM

• Optometrist in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.

Verify at the official NPI Registry.