Serena Ezzeddine, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

2010-01471 Issued in NC

Practice address

1900 Kildaire Farm Rd
Cary, NC 27518-6616

Phone

(919) 350-8228

Fax

(919) 350-7918

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Internal Medicine

Education

University of Miami, LM Miller School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Warner Physician Services PCGroup PAC ID 0345602801, 50 clinicians

Hospital Medicine Services of TN LLCGroup PAC ID 2365807633, 266 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Saint Thomas Hospital Hospital, Nashville, TN, CCN 440082
• Tristar Southern Hills Medical Center Hospital, Nashville, TN, CCN 440197

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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 Medicine Services of TN, LLC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1982301065
  Medicare reassignment Care Compare group NPD
• Warner Physician Services PC

  • Hospitalist Physician
  • Nashville, TN
  • NPI 1770272221
  Medicare reassignment Care Compare group NPD
• Saint Thomas Medical Partners

  dba Ascension Medical Group Saint Thomas

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment NPD
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians - Pediatric Hospitalists/Intensivists

  • Pediatric Critical Care Medicine Physician
  • Raleigh, NC
  • NPI 1013203819

  Hospitalist

  NPD (past)
• Wakemed Faculty Practice Plan

  dba WakeMed Faculty Physicians

  • Surgery Physician
  • Raleigh, NC
  • NPI 1396791786

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HCA Health Services of Tennessee, Inc.

  dba Tristar Southern Hills Medical Center

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1720032345
  Care Compare affiliation
• Saint Thomas West Hospital

  dba Ascension Saint Thomas Hospital

  • General Acute Care Hospital
  • Nashville, TN
  • NPI 1629025648
  Care Compare affiliation

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1154546729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8228",
            "fax_number": "919-350-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 KILDAIRE FARM RD",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275186616",
            "telephone_number": "919-350-8228",
            "fax_number": "919-350-7918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Church St # 102",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372366616",
            "country_code": "US",
            "telephone_number": "615-284-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZZEDDINE",
        "first_name": "SERENA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "50923",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2010-01471",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2010-01471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cary, NC
• Providers in Cary, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.