Sergio M Zaderenko, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0423954 Issued in KS

Practice address

8201 Mission Rd
Suite 261
Prairie Village, KS 66208

Phone

(913) 649-0923

Fax

(913) 649-0990

NPI assigned

Oct 24, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Gastrointestinal Associates, LLC

  • Gastroenterology Physician
  • Overland Park, KS
  • NPI 1619957123
  NPD (past)
• Mental Health Partners, PA

  • Psychiatry Physician
  • Prairie Village, KS
  • NPI 1528131976
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548344989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 MISSION RD",
            "address_2": "SUITE 261",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "66208",
            "telephone_number": "913-649-0923",
            "fax_number": "913-649-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8201 MISSION RD",
            "address_2": "SUITE 261",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "66208",
            "telephone_number": "913-649-0923",
            "fax_number": "913-649-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADERENKO",
        "first_name": "SERGIO",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0423954",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R6P58",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orria C Wood
• Mark William Wooddy, D.D.S.
• Meredith Lynn Woodring, M.S. CCC-SLP
• Sara Worley, PHARMD
• Elizabeth Wroe
• Adriana Maria Zavala
• Bailey Zehren, LMSW
• Adriane Susanne Zender, OTR/L
• Zong Hao Zhang, PHARMD
• Dallas Ray Ziegenhorn, D.D.S.

• Psychiatry Physician in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.