Sergei Pavlov, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

049584 Issued in ME

Practice address

300 Main St
Lewiston, ME 04240-7027

Phone

(207) 795-0111

Fax

(207) 753-7201

NPI assigned

Jun 18, 2006

Last updated

Dec 21, 2010By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson County Public Hospital District No 2Group PAC ID 4789593708, 151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Medicare reassignment Care Compare group NPD
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare Port Ludlow Clinic

  • Rural Health Clinic/Center
  • Port Ludlow, WA
  • NPI 1801188073
  NPD

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

• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare Swingbed

  • Medicare Defined Swing Bed Hospital Unit
  • Port Townsend, WA
  • NPI 1104950039
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  dba Jefferson Healthcare

  • Critical Access Hospital
  • Port Townsend, WA
  • NPI 1356492953
  Care Compare affiliation
• Jefferson County Public Hospital District No 2

  dba Sleep Medicine, Jefferson Healthcare

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Silverdale, WA
  • NPI 1467664631

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1649215187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-0111",
            "fax_number": "207-753-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407027",
            "telephone_number": "207-795-0111",
            "fax_number": "207-753-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOV",
        "first_name": "SERGEI",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-18",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "049584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hena J Patel
• Patricia Siragusa Engdahl LCSW, LLC
• David Gabriel Patrick, LCSW
• James Francis Patten
• Paul R Mailhot, MD, PA
• Kari Payne
• Peace Care Services LLC
• Isaac Peacock, DO
• Jacob Pearce
• Daniel Edward Pease, LADC/CCS

• Certified Registered Nurse Anesthetist in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Certified Registered Nurse Anesthetist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.