Seres Prime Healthcare

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SERES PRIME HEALTHCARE

Practice address

841 Blossom Hill Rd Ste 215
San Jose, CA 95123-2704

Phone

(408) 629-7095

Fax

(408) 281-8235

NPI assigned

Dec 3, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Daniel J Reyes-Villa, M.D.NPI 1013136563

Title

President

Phone

(408) 702-0991

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel J Reyes-Villa, M.D.

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1013136563
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1575331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1306483839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 BLOSSOM HILL RD STE 215",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232704",
            "telephone_number": "408-629-7095",
            "fax_number": "408-281-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 BLOSSOM HILL RD STE 215",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232704",
            "telephone_number": "408-629-7095",
            "fax_number": "408-281-8235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERES PRIME HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-03",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "REYES-VILLA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-702-0991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Gabrielle Seradilla
• Mohammad Seraj, BS , MA
• Erika Serame
• Serene Home Healthcare Inc.
• Serenity Gardens Rehab
• Lauren Gray McCartha Serkis, MSCP
• Jhoselyn Serna Bernabe
• Stephanie Serna
• Dylon Serpa
• Jocelyn Serrano Sanchez, ASW

• Primary Care Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.