Sergey Primakov

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015582-1 Issued in NY

Practice address

2 Crosfield Ave
West Nyack, NY 10994-2226

Phone

(845) 358-8989

Fax

(845) 358-8985

NPI assigned

Feb 5, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sportscare Physical Therapy of Ny, P.C.Group PAC ID 8123102092, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sportscare Physical Therapy of Ny, P.C.

  • Physical Therapist
  • West Nyack, NY
  • NPI 1003098138
  Medicare reassignment Care Compare group NPD
• Sportscare Institute, Inc.

  • Physical Therapist
  • Toms River, NJ
  • NPI 1275501074
  NPD (past)
• Sportscare of America, PC

  • Physical Therapist
  • East Hanover, NJ
  • NPI 1851484380
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881732378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-8989",
            "fax_number": "845-358-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CROSFIELD AVE",
            "city": "WEST NYACK",
            "state": "NY",
            "postal_code": "109942226",
            "telephone_number": "845-358-8989",
            "fax_number": "845-358-8985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIMAKOV",
        "first_name": "SERGEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015582-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "SP0QH48120",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerardo Posada, M.D.
• Matthew Vito Potenza, MD
• Jennifer Cimino Poterbin, FNP-BC
• Marc Price, DC
• Pamela Primakov
• Jeff Scott Pritsky, RPA-C
• Kristen Pupo, LCSW-R
• Jennifer A Quitadamo, L.AC
• Enzo A Ragucci, MD
• Karen Ramsey, COTA

• Physical Therapist in West Nyack, NY
• Providers in West Nyack, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.