Sergiy Berezhnoy, CO 60911229

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61200656 Issued in WA

Practice address

235 E Rowan Ave
Spokane, WA 99207-1240

Phone

(509) 252-6446

Fax

(509) 252-6490

NPI assigned

Nov 30, 2018

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group Washington PLLCGroup PAC ID 2264320837, 73 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/28594/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Privia Medical Group Washington, PLLC

  dba Walla Walla Clinic (Professional)

  • Clinic/Center
  • Walla Walla, WA
  • NPI 1780658419
  Medicare reassignment Care Compare group NPD
• Walla Walla Clinic, Inc.

  dba Walla Walla Clinic Milton-Freewater

  • Clinic/Center
  • Milton Freewater, OR
  • NPI 1063521862
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1881164978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14819 E MISSION AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992161960",
            "telephone_number": "509-315-9812",
            "fax_number": "509-474-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E ROWAN AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071240",
            "telephone_number": "509-252-6446",
            "fax_number": "509-252-6490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREZHNOY",
        "first_name": "SERGIY",
        "credential": "CO 60911229",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-30",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61200656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Boyd Bentley Jr., MD
• Eilidh Bentz
• Lalonie Laquetta Bentz, LICSWA
• Michele Marie Benz, L.M.P.
• Nicolle Rocina Marlene Benz, DO
• Estee Lee Berg, RN
• Evan Berg, LMT
• Jeffery C Berg
• Jill Christie Berg, SLP
• Kayla Berg

• Clinical Social Worker in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.