Organization Active NPI

Serenity OBGYN PLLC

  • Obstetrics & Gynecology Physician
  • Rochester Hills, MI
National Provider Identifier
1093590929
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SERENITY OBGYN PLLC
Practice address
3950 S Rochester Rd Ste 1450
Rochester Hills, MI 48307-5162
Phone
(248) 844-4550
NPI assigned
Aug 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Dina Kassab, DO
Title
DO
Phone
(248) 379-0489

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3950 S Rochester Rd Ste 1450
Rochester Hills, MI 48307-5162

Mailing address

3950 S Rochester Rd Ste 1450
Rochester Hills, MI 48307-5162
Phone (248) 378-0489

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230918003904 MI Part B Supplier - Clinic/Group Practice 9931563376 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

3950 S Rochester Rd
Ste 1450
Rochester Hills, MI 48307
Phone (248) 310-9486

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1093590929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 S ROCHESTER RD STE 1450",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075162",
            "telephone_number": "248-378-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 S ROCHESTER RD STE 1450",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075162",
            "telephone_number": "248-844-4550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY OBGYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "KASSAB",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "DO",
        "authorized_official_telephone_number": "248-379-0489",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.