Individual provider Active NPI

Alexander B Sevrukov, MD

  • Diagnostic Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1639278591
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD442738 Issued in PA
Practice address
132 S 10TH St Ste 3390
Philadelphia, PA 19107-5244
Phone
(800) 858-1662
Fax
(215) 923-1562
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2008021985 MO
Diagnostic Radiology Physician 2085R0202X 25MA10295900 NJ
Diagnostic Radiology Physician 2085R0202X MD442738 PA Primary

Addresses

Primary practice location

132 S 10TH St Ste 3390
Philadelphia, PA 19107-5244

Mailing address

132 S 10TH St Ste 3390
Philadelphia, PA 19107-5244
Phone (800) 858-1662

Other practice location 1

2301 S Broad St Fl 2
Philadelphia, PA 19148-3542
Phone (215) 952-9148

Other practice location 2

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

Other practice location 3

18 E Laurel Rd
Stratford, NJ 08084-1327
Phone (856) 346-6000

Other practice location 4

2201 Chapel Ave W
Cherry Hill, NJ 08002-2048
Phone (856) 488-6500

Other identifiers 2

IdentifierTypeStateIssuer
102624624MedicaidPA
0270695MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20110808000289 PA Practitioner - Diagnostic Radiology 1153471859 Reassigns benefits to 5 organizations
I20180618002842 NJ Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 1153471859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University Radiology Associates LLCGroup PAC ID 7315845708, shared by 3 NPIs, 110 clinicians
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians
Jefferson University Physicians of New Jersey PCGroup PAC ID 9931325131, 117 clinicians

Practice addresses (Care Compare)

1 W Germantown Pike
East Norriton, PA 19401-1513
Phone (610) 277-3202

10160 Bustleton Ave E
Jefferson Outpatient Imaging
Philadelphia, PA 19116-3749
Phone (215) 503-4900

111 S 11TH St
3Rd FLR Suite 3390
Philadelphia, PA 19107-5098
Phone (800) 858-1662

2211 Chapel Ave W
Suite 403
Cherry Hill, NJ 08002-2048
Phone (856) 922-5030

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012-2453
Phone (856) 582-2500

443 Laurel Oak Rd
Voorhees, NJ 08043-4419

650 Carnegie Blvd
Suite 240
Malvern, PA 19355-8519
Phone (215) 503-4900

850 Walnut St
Philadelphia, PA 19107-5109

999 Route 73 N 101
Jefferson Outpatient Imaging
Marlton, NJ 08053-1227
Phone (856) 424-2929

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008021985MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 6, 2011 Accepting new patients
Jeanes Radiology Associates LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Physicians Diagnostic Radiology CurrentSince Jul 18, 2011 Accepting new patients
Lebanon Diagnostic Imaging, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Jul 6, 2011 Accepting new patients
Jefferson University Physicians of New Jersey, P.C. CurrentSince Jan 9, 2019 Accepting new patients
Jefferson University Radiology Associates, LLC Diagnostic Radiology CurrentSince Sep 3, 2019 Accepting new patients
Rittenhouse Imaging Center, LLC Diagnostic Radiology CurrentSince Jul 24, 2020 Accepting new patients
Jefferson University Radiology Associates LLC Diagnostic Radiology Current Accepting new patients
Insight Health Corp PastSince Jul 24, 2020 Accepting new patients

Locations

2201 Chapel Ave W
Cherry Hill, NJ 08002
Phone (856) 488-6500

999 Route 73 N
Ste 101
Marlton, NJ 08053
Phone (856) 424-2929

18 E Laurel Rd
Stratford, NJ 08084
Phone (856) 346-6000

435 Hurffville Cross Keys Rd
Turnersville, NJ 08012
Phone (856) 513-4124

443 Laurel Oak Rd
Ste 130
Voorhees, NJ 08043
Phone (856) 741-0122

462 Gateway Ave
Chambersburg, PA 17201
Phone (717) 263-4999

150 E Pennsylvania Ave
Downingtown, PA 19335
Phone (215) 772-9674

850 Walnut St
Philadelphia, PA 19107
Phone (215) 503-4900

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

132 S 10th St
Ste 3390
Philadelphia, PA 19107
Phone (800) 581-6628

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

2301 S Broad St
Fl 2
Philadelphia, PA 19148
Phone (215) 952-9148

111 S 11th St
Ste 3390
Philadelphia, PA 19107
Phone (215) 955-2900

111 S 11th St
Fl 3
William Penn Annex West, PA 19107
Phone (215) 955-4804

Organizations & group practices 10

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 5

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1639278591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST STE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "800-858-1662",
            "fax_number": "215-923-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 S 10TH ST STE 3390",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075244",
            "telephone_number": "800-858-1662",
            "fax_number": "215-923-1562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 S Broad St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191483542",
            "country_code": "US",
            "telephone_number": "215-952-9148",
            "fax_number": "215-952-9965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "435 Hurffville Cross Keys Rd",
            "address_purpose": "LOCATION",
            "city": "Turnersville",
            "state": "NJ",
            "postal_code": "080122453",
            "country_code": "US",
            "telephone_number": "856-582-2500",
            "fax_number": "856-218-2096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18 E Laurel Rd",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "NJ",
            "postal_code": "080841327",
            "country_code": "US",
            "telephone_number": "856-346-6000",
            "fax_number": "856-346-6010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 Chapel Ave W",
            "address_purpose": "LOCATION",
            "city": "Cherry Hill",
            "state": "NJ",
            "postal_code": "080022048",
            "country_code": "US",
            "telephone_number": "856-488-6500",
            "fax_number": "856-922-5109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVRUKOV",
        "first_name": "ALEXANDER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2008021985",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA10295900",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD442738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102624624",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0270695",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.