Individual provider Active NPI

Kathrin Sandra Serrao, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Clifton, NJ
National Provider Identifier
1386179620
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA11589700 Issued in NJ
Practice address
1033 Clifton Ave Ste 108
Clifton, NJ 07013-3525
Phone
(973) 577-1995
NPI assigned
Apr 24, 2017
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 84503 SC
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA11589700 NJ Primary

Addresses

Primary practice location

1033 Clifton Ave Ste 108
Clifton, NJ 07013-3525

Mailing address

1033 Clifton Ave
Clifton, NJ 07013-3517
Phone (973) 577-1995

Other practice location 1

169 Ashley Ave
Charleston, SC 29425-3410
Phone (843) 792-7365

Other practice location 2

3600 Forbes Ave
forbes tower - plaza suite 140
Pittsburgh, PA 15213-3410
Phone (412) 647-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230406001747 NJ Practitioner - Endocrinology 9830462753 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1033 Clifton Ave
Suite 108
Clifton, NJ 07013-3525
Phone (973) 577-1995

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84503SCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Kathrin S Serrao MD LLC Endocrinology, Diabetes & Metabolism CurrentSince Jan 1, 2023 Accepting new patients

Locations

1033 Clifton Ave
Ste 108
Clifton, NJ 07013
Phone (973) 577-1995

515 N Wood Ave
Ste 302
Linden, NJ 07036
Phone (908) 925-3300

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1386179620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133517",
            "telephone_number": "973-577-1995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 CLIFTON AVE STE 108",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133525",
            "telephone_number": "973-577-1995"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294253410",
            "country_code": "US",
            "telephone_number": "843-792-7365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3600 Forbes Ave",
            "address_2": "forbes tower - plaza suite 140",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152133410",
            "country_code": "US",
            "telephone_number": "412-647-6340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRAO",
        "first_name": "KATHRIN",
        "middle_name": "SANDRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2022-08-04",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": "84503",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA11589700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.