Individual provider Active NPI

Sergey V Kulikov, MD

  • Neuroradiology Physician
  • Plymouth, MN
National Provider Identifier
1609294867
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
67360 Issued in MN
Practice address
2800 Campus Dr Ste 20
Plymouth, MN 55441-2669
Phone
(763) 559-2171
NPI assigned
Apr 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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 67360 MN
Neuroradiology Physician 2085N0700X 67360 MN Primary

Addresses

Primary practice location

2800 Campus Dr Ste 20
Plymouth, MN 55441-2669

Mailing address

2955 Xenium LN N Ste 40
Plymouth, MN 55441-2668
Phone (763) 559-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200619001082 MN Practitioner - Diagnostic Radiology 8022319193 Reassigns benefits to 3 organizations
I20230315000956 WI Practitioner - Diagnostic Radiology 8022319193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of North Dakota School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Imaging Partners LLCGroup PAC ID 1557734225, 29 clinicians
West Imaging LLCGroup PAC ID 7315833720, 29 clinicians
Minnesota Diagnostic Imaging Partners LLCGroup PAC ID 5890681209, 32 clinicians
Minneapolis Radiology Associates LTDGroup PAC ID 5698661007, 44 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Suite 103
Hudson, WI 54016-9919
Phone (763) 559-2171

2800 Campus Dr
Suite 20
Plymouth, MN 55441-2669
Phone (763) 398-8700

3300 Oakdale Ave N
Robbinsdale, MN 55422-2926
Phone (763) 520-2770

Hospital & facility affiliations

  • North Memorial Health Hospital Hospital, Robbinsdale, MN, CCN 240001
  • Maple Grove Hospital Hospital, Maple Grove, MN, CCN 240214
  • Centracare Health - Monticello Hospital, Monticello, MN, CCN 241362

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
67360MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Imaging Partners LLC Diagnostic Radiology CurrentSince Jan 3, 2023 Accepting new patients
West Imaging, LLC Diagnostic Radiology CurrentSince Jun 29, 2020 Accepting new patients
Minneapolis Radiology Associates, LTD. Neuroradiology CurrentSince Jun 29, 2020 Accepting new patients
Minnesota Diagnostic Imaging Partners, LLC Diagnostic Radiology CurrentSince Jun 29, 2020 Accepting new patients

Locations

9855 Hospital Dr
Ste 150
Maple Grove, MN 55369
Phone (763) 398-6341

2800 Campus Dr
Ste 20
Plymouth, MN 55441
Phone (763) 398-8700

2800 Campus Dr
Ste 10
Plymouth, MN 55441
Phone (763) 398-4400

2800 Campus Dr
Ste 30
Plymouth, MN 55441
Phone (763) 398-4000

2955 Xenium Ln N
Ste 40
Plymouth, MN 55441
Phone (763) 398-2203

3366 Oakdale Ave N
Ste 401
Robbinsdale, MN 55422
Phone (763) 398-6383

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

2651 Hillcrest Dr
Ste 103
Hudson, WI 54016
Phone (763) 559-2171

Interoperability endpoints

  • Direct secure messaging: skulikov519958@direct.centracare.com

Organizations & group practices 4

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 7

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1609294867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 XENIUM LN N STE 40",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412668",
            "telephone_number": "763-559-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 CAMPUS DR STE 20",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412669",
            "telephone_number": "763-559-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULIKOV",
        "first_name": "SERGEY",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "67360",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MN",
            "license": "67360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.