Anthony Jaime Serrato, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP95016430 Issued in CA

Practice address

2067 W Vista Way Ste 225
Vista, CA 92083-6001

Phone

(760) 630-2550

NPI assigned

Mar 2, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

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  Medicare reassignment NPD
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  Single Specialty

  NPD

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376138388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY STE 225",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836001",
            "telephone_number": "760-630-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY STE 225",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836001",
            "telephone_number": "760-630-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRATO",
        "first_name": "ANTHONY",
        "middle_name": "JAIME",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-02",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95016430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Oceanside",
            "affiliation": "N",
            "address_1": "526 Tukmal Dr",
            "city": "Oceanside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920580624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sequoia Affordable Housing Foundation
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• William Louis Sevier
• Sarah Christine Sevilla, DPT
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• Leila Shabanian, M.D.
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• Nurse Practitioner in Vista, CA
• Providers in Vista, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.