NPIMap

Individual provider Active NPI

Sergiy Nesterenko, M.D.

  • Orthopaedic Surgery Physician
  • Lubbock, TX
National Provider Identifier
1669631222
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
Q0326 Issued in TX
Practice address
2412 50TH St
Lubbock, TX 79412-2504
Phone
(806) 744-7223
Fax
(806) 740-3325
NPI assigned
Jun 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5384 ZZ
Orthopaedic Surgery Physician 207X00000X Q0326 TX Primary

Addresses

Primary practice location

2412 50TH St
Lubbock, TX 79412-2504

Mailing address

2804 N Loop 289
Lubbock, TX 79415-1410
Phone (806) 744-7223

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address snesterenko1250181@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140924001719 TX Practitioner - Orthopedic Surgery 6305094988 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Clinic of LubbockGroup PAC ID 5597768101, 44 clinicians

Practice addresses (Care Compare)

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Hospital & facility affiliations

  • Grace Surgical Hospital Hospital, Lubbock, TX, CCN 450162
  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040
  • University Medical Center Hospital, Lubbock, TX, CCN 450686
  • Plains Memorial Hospital Hospital, Dimmitt, TX, CCN 451350
  • Covenant Childrens Hospital Hospital, Lubbock, TX, CCN 453306

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion185
Laminectomy or laminotomy (partial removal of spine bones)24

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0326TXMDOrthopaedic Surgery Physician
5384ZZMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients
Grace Clinic of Lubbock Orthopaedic Surgery CurrentSince Jul 1, 2014 Accepting new patients
Grace Clinic of Lubbock CurrentSince Jul 1, 2014 Accepting new patients

Locations

2412 50th St
Lubbock, TX 79412
Phone (806) 788-4000

2804 N Loop 289
Lubbock, TX 79415
Phone (806) 740-3363

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

Interoperability endpoints

  • Direct secure messaging: nesterenko@yourcarecommunity.org
  • Direct secure messaging: snesterenko1250181@oc.providencedirect.org
  • Direct secure messaging: snesterenko91550@direct.metrohealth.org

Organizations & group practices 3

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 9

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": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1669631222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 N LOOP 289",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794151410",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122504",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTERENKO",
        "first_name": "SERGIY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ZZ",
            "license": "5384",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "Q0326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "snesterenko1250181@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4515 Marsha Sharp Fwy",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794072520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.