Individual provider Active NPI

Ricardo Benjamin Serrano, M.D.

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1104036987
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301088214 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-4886
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301088214 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

1121 Forestdale Rd
Royal Oak, MI 48067-1169
Phone (608) 215-6529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20090819000169 MI Practitioner - Anesthesiology 4385798818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Wisconsin School of Medicine, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (214) 687-0001

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301088214MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Jan 21, 2021 Accepting new patients

Locations

468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000

3601 W 13 Mile Rd
Royal Oak, MI 48073

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 1

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 3

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104036987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 FORESTDALE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671169",
            "telephone_number": "608-215-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "RICARDO",
        "middle_name": "BENJAMIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301088214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.