Andrei N Dokukin, MD

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

A110631 Issued in CA

Practice address

3939 Atlantic Ave Ste 223
Long Beach, CA 90807-3535

Phone

(562) 633-1765

Fax

(949) 502-8887

NPI assigned

Aug 13, 2009

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

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 1

Specialty

Physical Medicine and RehabilitationAlso: Addiction Medicine, Pain Management

Education

State University of New York Downstate Medical Center, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Erx Medical Group IncGroup PAC ID 4183073141, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Proprius Health Medical Group PC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Long Beach, CA
  • NPI 1447515911
  Medicare reassignment NPD Authorized official
• Roots Addiction and Psychiatry Medical Group, PC

  • Psychiatry Physician
  • Long Beach, CA
  • NPI 1205529252

  Addiction Medicine

  NPD Authorized official
• Erx Medical Group Inc

  • Family Medicine Physician
  • Van Nuys, CA
  • NPI 1851172712
  Care Compare group
• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421

  Interventional Pain Medicine

  NPD (past)
• Los Alamitos Medical Center, Inc.

  • Psychiatric Hospital Unit
  • Los Alamitos, CA
  • NPI 1497780084

  Interventional Pain Medicine

  NPD (past)
• Orange Coast Memorial Medical Center

  • General Acute Care Hospital
  • Fountain Valley, CA
  • NPI 1497702575

  Interventional Pain Medicine

  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Lakewood, CA
  • NPI 1184655581

  Interventional Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585008000000",
    "number": "1770715575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 W CHAPMAN AVE # 46",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682738",
            "telephone_number": "562-633-1765",
            "fax_number": "949-502-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 ATLANTIC AVE STE 223",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073535",
            "telephone_number": "562-633-1765",
            "fax_number": "949-502-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOKUKIN",
        "first_name": "ANDREI",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-13",
        "last_updated": "2020-03-24",
        "certification_date": "2020-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A110631",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A110631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL BOARD LICENSE",
            "identifier": "A110631",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER NUMBER",
            "identifier": "12086268",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briane Dohse, DPT
• Adrienne Yoshiko Doi, D.P.M.
• Dorene Akemi Doi, OTR
• Katherine Doi
• Marina Lagasca Dojillo, NP
• Geoffrey S Dolan, MD
• Riley Dolan, LCSW
• Mirou Pich Dom, MD
• Lawrence J Domaracki
• Silia Domat

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; 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.