Individual provider Active NPI

Derek Steven Serna, M.D.

  • Hematology & Oncology Physician
  • Waukesha, WI
National Provider Identifier
1205044773
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
69134 Issued in WI
Practice address
N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone
(262) 696-5690
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 35091934 OH
Hematology & Oncology Physician 207RH0003X 01069267A IN
Hematology & Oncology Physician 207RH0003X 69134 WI Primary

Addresses

Primary practice location

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106

Mailing address

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-5690

Other identifiers 2

IdentifierTypeStateIssuer
201035110MedicaidIN
000000721848OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180620003185 WI Practitioner - Medical Oncology 7911176391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Medical College of Wisconsin, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

N16W24131 Riverwood Dr
Waukesha, WI 53188-1106
Phone (262) 696-0808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35091934OHMDHematology & Oncology Physician
69134WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Jun 18, 2018 Accepting new patients
Prohealth Medical Group Inc CurrentSince Jun 18, 2018 Accepting new patients

Locations

791 Summit Ave
Summit, WI 53066
Phone (262) 569-0251

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

Interoperability endpoints

  • Direct secure messaging: dserna85414@direct.phci.org

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 4

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1205044773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N16W24131 RIVERWOOD DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881106",
            "telephone_number": "262-696-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N16W24131 RIVERWOOD DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881106",
            "telephone_number": "262-696-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERNA",
        "first_name": "DEREK",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "OH",
            "license": "35091934",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "IN",
            "license": "01069267A",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "69134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201035110",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000721848",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.