Active NPI
Regenass Healthcare Group
Doing business as Serenite Wellness Medicine
- Obesity Medicine (Preventive Medicine) Physician
- Ontario, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Preventive Medicine) Physician
- Legal business name
- REGENASS HEALTHCARE GROUP
- Doing business as
- Serenite Wellness Medicine
- Practice address
- 1910 S Archibald Ave Ste M2
Ontario, CA 91761-8502 - Phone
- (909) 348-2556
- Fax
- (877) 615-1555
- NPI assigned
- May 11, 2023
- Last updated
- May 11, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Dominador Mansat Jr., FNP-C
- Title
- Cfo
- Phone
- (909) 348-3067
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Preventive Medicine) Physician | 2083B0002X | Primary |
Addresses
Primary practice location
1910 S Archibald Ave Ste M2
Ontario, CA 91761-8502
Mailing address
9415 Retreat PL
Rancho Cucamonga, CA 91730-9200
Phone (909) 348-3067
Other names 1
- Serenite Wellness Medicine
National Provider Directory
National Provider DirectoryLocations
1910 S Archibald Ave
Ste M2
Ontario, CA 91761
Phone (909) 348-2556
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Ontario, CA
- NPI 1700500600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683763200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683763200000",
"number": "1104516350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9415 RETREAT PL",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917309200",
"telephone_number": "909-348-3067",
"fax_number": "877-615-1555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 S ARCHIBALD AVE STE M2",
"city": "ONTARIO",
"state": "CA",
"postal_code": "917618502",
"telephone_number": "909-348-2556",
"fax_number": "877-615-1555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REGENASS HEALTHCARE GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-11",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A",
"authorized_official_last_name": "MANSAT",
"authorized_official_first_name": "DOMINADOR",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "909-348-3067",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "FNP-C"
},
"taxonomies": [
{
"code": "2083B0002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Preventive Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Serenite Wellness Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Ontario, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.