Individual provider Active NPI

Mary Grace Tapawan-Serrano, M.D.

  • Family Medicine Physician
  • Yuba City, CA
National Provider Identifier
1053466326
Registry record updated Jun 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A82865 Issued in CA
Practice address
444 Plumas Blvd
Yuba City, CA 95991-5071
Phone
(530) 749-3420
NPI assigned
Jan 24, 2007
Last updated
Jun 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A82865 CA Primary

Addresses

Primary practice location

444 Plumas Blvd
Yuba City, CA 95991-5071

Mailing address

10470 Old Placerville Rd
#100
Sacramento, CA 95827-2539
Phone (866) 681-0736

Other identifiers 1

IdentifierTypeStateIssuer
00A828650MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150409001565 CA Practitioner - Family Practice 6406174200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

16911 Willow Glen Rd
Brownsville, CA 95919-9707
Phone (530) 675-2457

2800 L St
Sacramento, CA 95816-5616

400 Plumas Blvd
Suite 200
Yuba City, CA 95991-5081
Phone (530) 749-5560

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A82865CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Family Medicine Current Accepting new patients
Sutter Valley Medical Foundation Family Medicine CurrentSince Apr 1, 2015 Accepting new patients
Sutter Regional Medical Foundation Family Medicine Past Accepting new patients
Rideout Memorial Hospital Past Accepting new patients
Sutter North Medical Foundatoin Past Accepting new patients

Locations

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: mtapawanserrano238290@hisp.ehr.sutterhealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434067200000",
    "number": "1053466326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "#100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "866-681-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 PLUMAS BLVD",
            "city": "YUBA CITY",
            "state": "CA",
            "postal_code": "959915071",
            "telephone_number": "530-749-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPAWAN-SERRANO",
        "first_name": "MARY",
        "middle_name": "GRACE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A82865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A828650",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuba City, CA

Sources for this page

Verify at the official NPI Registry.