Serena Siu, DO

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

799 Bloomfield Ave Ste 201
Verona, NJ 07044-1301

Phone

(973) 746-7050

NPI assigned

Apr 3, 2023

Last updated

Apr 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: ssiu868725@ahs.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Montclair Hospital LLC

  dba Mountainside Family Practice Associates

  • Primary Care Clinic/Center
  • Verona, NJ
  • NPI 1295983484
  NPD (past)
• Mountainside Family Practice Associates - Merit

  • Family Medicine Physician
  • Verona, NJ
  • NPI 1528199890
  NPD (past)

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1164127841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 BLOOMFIELD AVE STE 201",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 BLOOMFIELD AVE STE 201",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "070441301",
            "telephone_number": "973-746-7050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Bay Ave",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070424837",
            "country_code": "US",
            "telephone_number": "973-429-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIU",
        "first_name": "SERENA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oleg Shulik, M.D.
• Gina Signorelli, IBCLC, RDN
• Andrea Silk
• Simply Chiropractic Verona LLC
• Paul William Sirna, M.D.
• Kannan Sivaraju
• Gregory E Skroce, L.AC.
• Sleephub at Verona LLC
• Colleen Snyder, PA
• Mariusz Sobilo, PA-C

• Student in an Organized Health Care Education/Training Program in Verona, NJ
• Providers in Verona, NJ by specialty
• Student in an Organized Health Care Education/Training Program in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.