Individual provider Active NPI

Sergei Dolgopolov, MD

  • Surgery Physician
  • New York, NY
National Provider Identifier
1902995129
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
218924 Issued in NY
Practice address
122 E 76TH St
1B
New York, NY 10021
Phone
(212) 628-8771
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 218924 NY Primary

Addresses

Primary practice location

122 E 76TH St
1B
New York, NY 10021

Mailing address

155 E 76TH St Apt 1C
New York, NY 10021-2811
Phone (212) 988-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20100512000056 NY Practitioner - General Surgery 0244250017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lenox Hill Surgeons, LLPGroup PAC ID 2264798891, 2 clinicians

Practice addresses (Care Compare)

155 E 76TH St
Apt 1C
New York, NY 10021-2811
Phone (212) 988-1136

Hospital & facility affiliations

  • Mount Sinai Hospital Hospital, New York, NY, CCN 330024
  • Lenox Hill Hospital Hospital, New York, NY, CCN 330119

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Colonoscopy1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
218924NYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lenox Hill Surgeons, LLP Surgery CurrentSince Oct 1, 2017 Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sdolgopolov65635@northwell.direct-ci.com

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1902995129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E 76TH ST APT 1C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212811",
            "telephone_number": "212-988-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E 76TH ST",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "212-628-8771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLGOPOLOV",
        "first_name": "SERGEI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "218924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.