Sergey Masterov, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501003883 Issued in MI

Practice address

28300 Franklin Rd Ste a
Southfield, MI 48034-1657

Phone

(248) 354-8180

Fax

(248) 354-8199

NPI assigned

Aug 26, 2021

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1710654769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28300 FRANKLIN RD STE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341657",
            "telephone_number": "248-354-8180",
            "fax_number": "248-354-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28300 FRANKLIN RD STE A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341657",
            "telephone_number": "248-354-8180",
            "fax_number": "248-354-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTEROV",
        "first_name": "SERGEY",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501003883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophie Masri
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• Ryan William Mast, TLLP
• Madelyn Sue Mastenbrook
• Master Medical, PLLC
• Sabrina Lauren Mastronardi, PHARMD
• Johanna E Mastry, RPT
• Lori Ann Matheson, LLPC
• Nancy K Mathew, RPT
• Toms K Mathew, RPT

• Massage Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.