NPIMap

Individual provider Active NPI

David Serur, M.D.

  • Nephrology Physician
  • Hackensack, NJ
National Provider Identifier
1023070851
Registry record updated Feb 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25MA10750100 Issued in NJ
Practice address
20 Prospect Ave Ste 406
Hackensack, NJ 07601-1941
Phone
(551) 996-2608
Fax
(551) 996-0826
NPI assigned
Apr 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 179375 NY
Nephrology Physician 207RN0300X 25MA10750100 NJ Primary

Addresses

Primary practice location

20 Prospect Ave Ste 406
Hackensack, NJ 07601-1941

Mailing address

20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-2608

Other identifiers 1

IdentifierTypeStateIssuer
01467069MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200303001542 NJ Practitioner - Nephrology 0547456493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
State University of New York Downstate Medical Center, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20 Prospect Ave
Hackensack, NJ 07601-1997
Phone (551) 996-5045

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.33 of 100Reported as group
Quality
66.38
Promoting interoperability
100
Improvement activities
40
Cost
71.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10750100NJMDNephrology Physician
179375NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Feb 10, 2020 Accepting new patients
Hackensack Meridian Health Medical Group - Specialty Care PC CurrentSince Feb 10, 2020 Accepting new patients

Locations

20 Prospect Ave
Hackensack, NJ 07601
Phone (201) 996-2816

20 Prospect Ave
Ste 406
Hackensack, NJ 07601
Phone (551) 996-2608

30 Prospect Ave
Hackensack, NJ 07601
Phone (201) 488-0066

3600 State Route 66
Fl 3
Neptune City, NJ 07753
Phone (732) 807-0463

Interoperability endpoints

  • Direct secure messaging: david.serur@direct.hackensackmeridian.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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 9

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1023070851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011997",
            "telephone_number": "551-996-2608",
            "fax_number": "551-996-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 406",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011941",
            "telephone_number": "551-996-2608",
            "fax_number": "551-996-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERUR",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "179375",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NJ",
            "license": "25MA10750100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01467069",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.