Individual provider Active NPI

Sergey Kochkine, M.D.

  • Diagnostic Radiology Physician
  • Stony Brook, NY
National Provider Identifier
1538450010
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
286933 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-6402
Phone
(631) 444-5400
NPI assigned
May 2, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 286933 NY Primary
Diagnostic Radiology Physician 2085R0202X 253272 MA

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-6402

Mailing address

PO Box 1559
Stony Brook, NY 11790-0989
Phone (718) 404-2322

Other practice location 1

55 Fruit St
Boston, MA 02114-1552
Phone (617) 724-5246

Other practice location 2

560 1st Ave
New York, NY 10016-6402
Phone (212) 263-5230

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180326001806 NY Practitioner - Diagnostic Radiology 6608165691 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-3407
Phone (631) 638-2121

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-5400

201 Manor PL
Greenport, NY 11944-1222
Phone (631) 477-1000

Hospital & facility affiliations

  • Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
  • Long Island Community Hospital Hospital, Patchogue, NY, CCN 330141

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Radiology, University Faculty Practice Corporation Diagnostic Radiology CurrentSince May 1, 2023 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
New York University CurrentSince May 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Diagnostic Radiology CurrentSince Aug 29, 2022 Accepting new patients
Columbiadoctors/Newyork-Presbyterianimaging CurrentSince Aug 29, 2022 Accepting new patients
New York University CurrentSince May 1, 2018 Accepting new patients
Radiological Consultants, Inc. Diagnostic Radiology PastSince Sep 26, 2016 Accepting new patients

Locations

560 1st Ave
New York, NY 10016
Phone (212) 263-5362

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

51 W 51st St
Ste 300
New York, NY 10019
Phone (212) 342-3666

13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 8

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 8

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1538450010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1559",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117900989",
            "telephone_number": "718-404-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117946402",
            "telephone_number": "631-444-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021141552",
            "country_code": "US",
            "telephone_number": "617-724-5246",
            "fax_number": "617-724-7140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "560 1st Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100166402",
            "country_code": "US",
            "telephone_number": "212-263-5230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCHKINE",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NY",
            "license": "286933",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "253272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.