Individual provider Active NPI

Sergiy Kushchayev, MD PHD

  • Diagnostic Radiology Physician
  • Lutz, FL
National Provider Identifier
1669810271
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME140132 Issued in FL
Practice address
17329 Ladera Estates Blvd
Lutz, FL 33548-4817
Phone
(813) 745-7365
Fax
(813) 449-8618
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME140132 FL Primary

Addresses

Primary practice location

17329 Ladera Estates Blvd
Lutz, FL 33548-4817

Mailing address

PO Box 198441
Atlanta, GA 30384-8441
Phone (813) 745-7365

Other practice location 1

12902 Usf Magnolia Dr Fl 33612
Tampa, FL 33612-9416
Phone (813) 745-1573

Other identifiers 1

IdentifierTypeStateIssuer
1669810271MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CT2 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
I20190905001718 FL Practitioner - Diagnostic Radiology 0042568180 Reassigns benefits to 5 organizations
I20250819000161 CT Practitioner - Diagnostic Radiology 0042568180 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Imaging Partners LLCGroup PAC ID 4183649098, 105 clinicians
Tic LLCGroup PAC ID 4880972819, 52 clinicians
Farmington Imaging Center LLCGroup PAC ID 7719265651, 68 clinicians
Jefferson Radiology PCGroup PAC ID 8729982525, 121 clinicians

Practice addresses (Care Compare)

100 Hazard Ave
Suite 100
Enfield, CT 06082-5447
Phone (860) 289-3375

17329 Ladera Estates Blvd
Lutz, FL 33548-4817
Phone (860) 289-3375

399 Farmington Ave
Suite 130
Farmington, CT 06032-1944
Phone (860) 289-3375

6 Fieldstone CMNS
Suite E
Tolland, CT 06084-3419
Phone (860) 896-4848

85 Seymour St
Suite 200
Hartford, CT 06106-5509
Phone (860) 289-3375

Hospital & facility affiliations

  • Hartford Hospital Hospital, Hartford, CT, CCN 070025
  • Manchester Memorial Hospital Hospital, Manchester, CT, CCN 070027
  • Griffin Hospital Hospital, Derby, CT, CCN 070031
  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003
  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Merit-based Incentive Payment System (MIPS)

Final score
88 of 100Reported as group
Quality
74.04
Promoting interoperability
100
Improvement activities
40
Cost
70.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Imaging Partners, LLC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Tic, LLC Diagnostic Radiology CurrentSince Jan 16, 2025 Accepting new patients
Farmington Imaging Center, LLC Diagnostic Radiology CurrentSince Dec 11, 2024 Accepting new patients
Partners Imaging Center of Sarasota LLC Diagnostic Radiology CurrentSince Apr 17, 2024 Accepting new patients
Jefferson Radiology, PC Diagnostic Radiology CurrentSince Sep 1, 2024 Accepting new patients
Mori Bean and Brooks Inc Diagnostic Radiology PastSince May 1, 2022 Accepting new patients
Partners Imaging Center of Bradenton Past Accepting new patients

Locations

100 Hazard Ave
Ste 100
Enfield, CT 06082
Phone (860) 696-2380

399 Farmington Ave
Lowr 1
Farmington, CT 06032

399 Farmington Ave
Ste 130
Farmington, CT 06032

85 Seymour St
Ste 200
Hartford, CT 06106
Phone (860) 246-6589

6 Fieldstone Cmns
Ste E
Tolland, CT 06084
Phone (860) 896-4847

1260 Silas Deane Hwy
Ste 104
Wethersfield, CT 06109
Phone (860) 563-7844

5101 4th Avenue Cir E
Ste 100
Bradenton, FL 34208
Phone (941) 782-0414

1250 S Tamiami Trl
Ste 101
Sarasota, FL 34239
Phone (941) 951-2100

1250 S Tamiami Trl
Ste 103
Sarasota, FL 34239
Phone (941) 894-3332

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ei-jefferson

Organizations & group practices 7

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 7

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1669810271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198441",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848441",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17329 LADERA ESTATES BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335484817",
            "telephone_number": "813-745-7365",
            "fax_number": "813-449-8618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12902 Usf Magnolia Dr Fl 33612",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336129416",
            "country_code": "US",
            "telephone_number": "813-745-1573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSHCHAYEV",
        "first_name": "SERGIY",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME140132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669810271",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12902 Usf Magnolia Dr Fl 33612",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336129416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

Verify at the official NPI Registry.