Sergii Khodakivskyi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A174583 Issued in CA

Practice address

1150 N Indian Canyon Dr
Palm Springs, CA 92262-4872

Phone

(951) 764-2863

NPI assigned

Jun 1, 2018

Sex

Male

Sole proprietor

Yes

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 CA

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

Specialty

Internal Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fountain Valley Group Services PCGroup PAC ID 9931427382, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• John F Kennedy Memorial Hospital Hospital, Indio, CA, CCN 050534
• Desert Regional Medical Center Hospital, Palm Springs, CA, CCN 050243
• Eisenhower Medical Center Hospital, Rancho Mirage, CA, CCN 050573
• Hi-Desert Medical Center Hospital, Joshua Tree, CA, CCN 050279
• El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

Merit-based Incentive Payment System (MIPS)

Final score

85.6 of 100Reported as group

Quality

64.37

Promoting interoperability

100

Improvement activities

40

Cost

72.88

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (8 of 9)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Fountain Valley Group Services PC

  • Hospitalist Physician
  • Indio, CA
  • NPI 1013310309

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Desert Physicians Medical Group Health

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1134742703

  Single Specialty

  Medicare reassignment NPD
• Desert Group Services, PC

  • Hospitalist Physician
  • Joshua Tree, CA
  • NPI 1891240602
  Medicare reassignment
• White Feather Physicians PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Joshua Tree, CA
  • NPI 1710595392
  Medicare reassignment
• First Choice Physician Partners

  • Neurological Surgery Physician
  • Modesto, CA
  • NPI 1104183052

  Single Specialty

  NPD
• First Choice Physician Partners

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1558797118

  Single Specialty

  NPD
• First Choice Physician Partners

  • Ophthalmology Physician
  • El Monte, CA
  • NPI 1912732892
  NPD
• Fountain Valley Group Services PC

  • Critical Care Medicine (Internal Medicine) Physician
  • Indio, CA
  • NPI 1194670349
  NPD (past)
• Hi-Desert Medical Center

  • Radiology Clinic/Center
  • Joshua Tree, CA
  • NPI 1477683951

  Single Specialty

  NPD (past)
• Diagnostic Imaging Services

  • Magnetic Resonance Imaging (MRI) Internal Medicine Physician
  • Metairie, LA
  • NPI 1699793166

  Single Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Desert Regional Medical Center, Inc.

  • General Acute Care Hospital
  • Palm Springs, CA
  • NPI 1104856095
  Care Compare affiliation
• Eisenhower Medical Center

  • General Acute Care Hospital
  • Rancho Mirage, CA
  • NPI 1013981554
  Care Compare affiliation
• El Centro Regional Medical Center

  • General Acute Care Hospital
  • El Centro, CA
  • NPI 1861409823
  Care Compare affiliation
• HDMC Holdings, LLC

  • General Acute Care Hospital
  • Joshua Tree, CA
  • NPI 1851787295
  Care Compare affiliation
• JFK Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Indio, CA
  • NPI 1477584993
  Care Compare affiliation

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1609368935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELMONTE DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922119073",
            "telephone_number": "917-724-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N INDIAN CANYON DR",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922624872",
            "telephone_number": "951-764-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODAKIVSKYI",
        "first_name": "SERGII",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-01",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A174583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahrukh Khan, DO
• Sina Khanbabakhani, DDS
• Prerna Mona Khanna, MD
• Babak Khazaeni, M.D
• Olga Khodakivska
• Jonathan Nguyen Khoi, DDS
• Angel Khokhar, MD
• Liyona Khoury
• Reema Khurram, MD
• Helen Kienzle, PHD

• Internal Medicine Physician in Palm Springs, CA
• Providers in Palm Springs, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.