SERGEY SHUSHUNOV (NPI# 1588632681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588632681 |
| Entity Type | Individual |
| Full Name | SERGEY SHUSHUNOV |
| Credential | MD |
| Practice Address |
Division of Pediatric Critical Care 3901 Rainbow Blvd Kansas City KS 66160-0001 |
| Mailing Address |
3385 N Arlington Heights Rd. Suite A Arlington Heights IL 60004 |
| Practice Telephone | 9135886363 |
| Mailing Telephone | 8479621858 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-04-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
036070073 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | JOHN DEERE | IL0104 | 01 |
| IL | BCBS | 07215036 | 01 |
| IL | 036070073 | 05 |
| Street Address |
DIVISION OF PEDIATRIC CRITICAL CARE 3901 RAINBOW BLVD |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66160-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215541594 | Julian Diaz Abele | Plastic Surgery | 40000 Cambridge St. Sutherland Institute, Ms3015, Kansas City, KS 66160 | 2020-09-03 |
| 1831650670 | Autumn Brubaker | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd Ste Ms 2027, Kansas City, KS 66160 | 2019-03-26 |
| 1851886949 | Adam Kahle | Surgery | 4000 Cambridge, Department of Surgery, M/s 2005, Kansas City, KS 66160 | 2018-06-29 |
| 1871086876 | Mirna Asham | Student in an Organized Health Care Education/Training Program | Medical Office Building, 2000 Olathe Blvd, Kansas City, KS 66160 | 2018-06-13 |
| 1811491012 | Daniel Martin Kolm | Emergency Medicine | 2106 Olathe Blvd Ms 1060, Kansas City, KS 66160 | 2018-03-21 |
| 1417451642 | Heather Schopper | Otolaryngology | 3901 Rainbow Blvd # Ms 1060, Kansas City, KS 66160 | 2018-03-21 |
| 1508360207 | Rachel Guest | Student in an Organized Health Care Education/Training Program | Kansas University Medical Center 4000 Cambridge St, Kansas City, KS 66160 | 2018-03-19 |
| 1891218541 | Elizabeth Swarna Mukherjee | Family Medicine | 2000 Olathe Blvd, Kansas City, KS 66160 | 2017-07-24 |
| 1609304112 | Zihan Masood | Neurological Surgery | The University of Kansas Medical Center, 3901 Rainbow Blvd, Ms 3021, Kansas City, KS 66160 | 2017-05-28 |
| 1144752601 | Lindsay Marie Baldridge | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd. M/s 4004, University of Kansas Pediatrics Residency, Kansas City, KS 66160 | 2017-04-03 |
| Find all providers in zip 66160 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174966055 | Stephen Pfeiffer | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2013-04-10 |
| 1992070189 | Sarah Devlin Brunner | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2012-03-20 |
| 1255631867 | Hammad Ashraf Ganatra | Pediatrics | 3901 Rainbow Blvd, Miller 2023, Kansas City, KS 66160 | 2010-10-29 |
| 1376785840 | Jay Frederick Rilinger | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2009-03-30 |
| 1144438250 | Francesca Perez Marques | Pediatrics | 3901 Rainbow Blvd, M 2023, Kansas City, KS 66160-8500 | 2007-05-21 |
| 1760510572 | Brian Stevens Olsen | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2007-03-01 |
| 1598716243 | Kelly S Tieves | Pediatrics | 2401 Gillham Rd, Children's Mercy Hospital, Kansas City, MO 64108-4619 | 2006-05-15 |
| 1497705933 | Geoffrey L Allen | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-12 |
| 1356391189 | John Fred Sommerauer | Pediatrics | 2401 Gillham Rd, Kansas City, MO 64108-4619 | 2006-05-11 |
| 1053369686 | Stephen A Klem | Pediatrics | 2401 Gillham Rd, Children's Mercy Hospital, Kansas City, MO 64108-4619 | 2006-05-05 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 66160 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.