Individual provider Active NPI

Pura Garcia-Serrablo, PSY.D.

  • Psychiatric Hospital Unit
  • Bayside, NY
National Provider Identifier
1033579446
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
Practice address
21006 42ND Ave
Apt. 1E
Bayside, NY 11361-2771
Phone
(215) 221-4484
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X Primary

Addresses

Primary practice location

21006 42ND Ave
Apt. 1E
Bayside, NY 11361-2771

Mailing address

21006 42ND Ave
Apt. 1E
Bayside, NY 11361-2771
Phone (215) 221-4484

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20181128001328 DC Practitioner - Clinical Psychologist 3274877543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

1145 19TH St NW
311 MMG at 19TH Street NW
Washington, DC 20036-3735
Phone (202) 429-2401

Merit-based Incentive Payment System (MIPS)

Final score
82.34 of 100Reported as group
Quality
67.9
Promoting interoperability
100
Improvement activities
40
Cost
69.47

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2021 Accepting new patients
Medstar Medical Group II LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

102 Irving St NW
Washington, DC 20010
Phone (202) 877-1587

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.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1033579446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21006 42ND AVE",
            "address_2": "APT. 1E",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612771",
            "telephone_number": "215-221-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21006 42ND AVE",
            "address_2": "APT. 1E",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612771",
            "telephone_number": "215-221-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-SERRABLO",
        "first_name": "PURA",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

Verify at the official NPI Registry.