Organization Active NPI

Serebnitsky Pain Medicine, PC

  • Interventional Pain Medicine Physician
  • New York, NY
National Provider Identifier
1609518158
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
SEREBNITSKY PAIN MEDICINE, PC
Practice address
68 E 131St St
New York, NY 10037-2900
Phone
(718) 288-7026
NPI assigned
Apr 13, 2022
Last updated
Apr 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Stacy Serebnitsky, MDNPI 1336379817
Title
Medical Director
Phone
(718) 288-7026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU
Interventional Pain Medicine Physician 208VP0014X NU Primary

Addresses

Primary practice location

68 E 131St St
New York, NY 10037-2900

Mailing address

11201 Queens Blvd Apt 18G
Forest Hills, NY 11375-5592
Phone (718) 288-7026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1609518158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 QUEENS BLVD APT 18G",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755592",
            "telephone_number": "718-288-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 E 131ST ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100372900",
            "telephone_number": "718-288-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEREBNITSKY PAIN MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "SEREBNITSKY",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "718-288-7026",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.