Jesus Canoza Serrano, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

155047 Issued in NY

Practice address

140 Pleasant Ave
Englewood, NJ 07631-1604

Phone

(201) 783-7033

NPI assigned

Dec 1, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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 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.

• All Axis Medical PC

  • Internal Medicine Physician
  • Ozone Park, NY
  • NPI 1083177711
  NPD Authorized official
• Rockland Psychiatric Center

  • Long Term Care Hospital
  • Englewood, NJ
  • NPI 1457411266
  NPD (past) Authorized official

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1225283401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PLEASANT AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PLEASANT AVE",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076311604",
            "telephone_number": "201-783-7033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "JESUS",
        "middle_name": "CANOZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-01",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "155047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "155047",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Tiffany Senatore
• Rohun Sendhey
• Chang Joo Seo, MD
• Christina J. Seo, MD
• Ro Mi Seo
• Carmela Seymour, M.D.
• Larissa Seymour, LCSW
• Barbara Shackford, CRNA
• Aditi Shah
• Asit Kantilal Shah, MD

• Internal Medicine Physician in Englewood, NJ
• Providers in Englewood, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; 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.