Individual provider Active NPI

Roberto Serrano, MD

  • Community Health Clinic/Center
  • Caguas, PR
National Provider Identifier
1073820320
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
License
020569 Issued in PR
Practice address
A5 Calle Campeche
Quintas de San Luis II
Caguas, PR 00725-7607
Phone
(787) 747-1650
NPI assigned
Sep 8, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X 020569 PR Primary

Addresses

Primary practice location

A5 Calle Campeche
Quintas de San Luis II
Caguas, PR 00725-7607

Mailing address

A5 Calle Campeche
Quintas de San Luis II
Caguas, PR 00725-7607
Phone (787) 747-1650

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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
I20150619001759 PR Practitioner - General Practice 5597076372 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020569PRMDCommunity Health Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince Mar 7, 2015 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Mar 7, 2015 Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1073820320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A5 CALLE CAMPECHE",
            "address_2": "QUINTAS DE SAN LUIS II",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007257607",
            "telephone_number": "787-747-1650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A5 CALLE CAMPECHE",
            "address_2": "QUINTAS DE SAN LUIS II",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007257607",
            "telephone_number": "787-747-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "ROBERTO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "PR",
            "license": "020569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caguas, PR

Sources for this page

Verify at the official NPI Registry.