Individual provider Active NPI

Sergey Semenov, PHARMD, RPH, MPH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1780810200
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
048741 Issued in NY
Practice address
1201 Avenue Z
Brooklyn, NY 11235-4301
Phone
(917) 933-4000
Fax
(917) 933-4004
NPI assigned
Jun 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048741 NY Primary

Addresses

Primary practice location

1201 Avenue Z
Brooklyn, NY 11235-4301

Mailing address

1201 Avenue Z
Brooklyn, NY 11235-4301
Phone (917) 933-4000

Other identifiers 1

IdentifierTypeStateIssuer
048741OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
048741NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sos Pharmacy Inc CurrentSince Jun 21, 2020 Accepting new patients
Quick Stop Pharmacy, Inc Past Accepting new patients

Locations

1201 Avenue Z
Brooklyn, NY 11235
Phone (917) 933-4000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1780810200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354301",
            "telephone_number": "917-933-4000",
            "fax_number": "917-933-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 AVENUE Z",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112354301",
            "telephone_number": "917-933-4000",
            "fax_number": "917-933-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMENOV",
        "first_name": "SERGEY",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "048741",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.