Michael Serrano

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP8025 Issued in AZ

Practice address

3505-A Western Ave
Kingman, AZ 86409

Phone

(928) 757-8111

Fax

(928) 757-3256

NPI assigned

Aug 17, 2015

Last updated

Sep 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mohave Mental Health Clinic IncGroup PAC ID 7618963935, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mohave Mental Health Clinic Inc

  • Clinic/Center
  • Kingman, AZ
  • NPI 1902894272
  Medicare reassignment Care Compare group NPD
• Community Partners Integrated Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Tucson, AZ
  • NPI 1669897385
  NPD (past)
• Corazon Inc.

  dba Corazon Behavioral Health Service

  • Health Maintenance Organization
  • Nogales, AZ
  • NPI 1508160946
  NPD (past)
• Advanced Psychological Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mankato, MN
  • NPI 1053066902

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1346616174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 N STOCKTON HILL RD STE B",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864090507",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505-A WESTERN AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "86409",
            "telephone_number": "928-757-8111",
            "fax_number": "928-757-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-17",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BN",
            "identifier": "AP8025",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045089",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ NB",
            "identifier": "RN187990",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Derek Schwendemann
• Kathy Kay Scroggins
• Yivette Scroggins
• Akilan Selvaraju, D.O.
• Joe Ren'E Serna, M.D.
• Jonathon Allen Sexton, DO
• Traniece Seymour
• Jennifer Ann Shade
• Belal Mohammad Sharaf, MD
• Sheehan FNP PLLC

• Psychiatric/Mental Health Nurse Practitioner in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.