Individual provider Active NPI

Desirae Serrano

  • Nurse Practitioner
  • Waterville, ME
National Provider Identifier
1104565837
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP221009 Issued in ME
Practice address
211 Main St
Waterville, ME 04901-6117
Phone
(207) 877-3400
Fax
(207) 877-3401
NPI assigned
Jun 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP221009 ME Primary

Addresses

Primary practice location

211 Main St
Waterville, ME 04901-6117

Mailing address

211 Main St
Waterville, ME 04901-6117
Phone (207) 877-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220614002340 ME Practitioner - Nurse Practitioner 1850770322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mainegeneral Medical CenterGroup PAC ID 1254245715, 554 clinicians

Practice addresses (Care Compare)

211 Main St
Waterville, ME 04901-6117
Phone (207) 877-3400

Hospital & facility affiliations

  • Mainegeneral Community Care Home health agency, Waterville, ME, CCN 207021
  • Maine General Medical Center Hospital, Augusta, ME, CCN 200039
  • Redington Fairview General Hospital Hospital, Skowhegan, ME, CCN 201314

Merit-based Incentive Payment System (MIPS)

Final score
86.22 of 100Reported as group
Quality
75.39
Promoting interoperability
84
Improvement activities
40
Cost
75.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP221009MEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainegeneral Medical Center CurrentSince Jun 6, 2022 Accepting new patients
Mainegeneral Medical Center CurrentSince Jun 6, 2022 Accepting new patients

Locations

211 Main St
Waterville, ME 04901
Phone (207) 877-3400

149 North St
Waterville, ME 04901
Phone (207) 622-1959

Interoperability endpoints

  • Direct secure messaging: desiraeserrano@mgh.allscriptsdirect.net

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.

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": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1104565837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016117",
            "telephone_number": "207-877-3400",
            "fax_number": "207-877-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MAIN ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049016117",
            "telephone_number": "207-877-3400",
            "fax_number": "207-877-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "DESIRAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP221009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterville, ME

Sources for this page

Verify at the official NPI Registry.