Sergey Smirnov, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11005649 Issued in FL

Practice address

255 Rivertown Shops Dr Ste 102-161
St Johns, FL 32259-7506

Phone

(904) 377-3154

NPI assigned

Oct 26, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Wound CareGroup PAC ID 3375074834, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ssmirnov840437@nychhc.direct-ci.com

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.

• Paragon Wound Care

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1568296689
  Medicare reassignment Care Compare group NPD Authorized official
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1124252333
  Medicare reassignment NPD
• Sound Physicians of Florida VI LLC

  • Internal Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1417761073
  Medicare reassignment NPD
• Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Port Orange, FL
  • NPI 1861150625
  NPD

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

{
    "created_epoch": "1572048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1699318295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6629 BROADWAY APT 5C",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104712040",
            "telephone_number": "646-552-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 RIVERTOWN SHOPS DR STE 102-161",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322597506",
            "telephone_number": "904-377-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIRNOV",
        "first_name": "SERGEY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-26",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345197",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Joshua Simms, LAT, ATC
• Detra Shauntel Simpo, OTR/L
• Ethan M Sincoff, LMHC
• Courtney Skipworth, RN, IBCLC
• Nicholas Laray Slunaker II
• Ameea Smith
• Jessica Lynn Smith, NP-C
• Jonyetta Smith
• Lakenya Brenae Smith, BEHAVIOR TECHNICIAN
• Maria Lea Alap-Ap Smith

• Family Nurse Practitioner in St Johns, FL
• Providers in St Johns, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.