Serena Jiddou, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

258297 Issued in MA

Practice address

2100 Dorchester Ave
Dorchester, MA 02124

Phone

(248) 686-4844

NPI assigned

Jun 30, 2010

Last updated

Aug 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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 Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jiddou.serena.nwh@direct.partners.masshiway.net
• Direct secure messaging: serena.jiddou@direct.signature.masshiway.net

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.

• Steward Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Ayer, MA
  • NPI 1780971275
  Medicare reassignment NPD
• Mass General Brigham Medical Group, Inc.

  • Internal Medicine Physician
  • Salem, NH
  • NPI 1083360200

  MA

  Medicare reassignment NPD
• Newton Wellesley Emergency Medicine Specialist, P .C.

  • Emergency Medicine Physician
  • Newton, MA
  • NPI 1346355526
  Medicare reassignment
• Newton Wellesley Hospital

  • General Acute Care Hospital
  • Newton, MA
  • NPI 1952845521
  NPD

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1396056826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "248-686-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "248-686-4844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7400",
            "fax_number": "508-941-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Dorchester Ave",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "02124",
            "country_code": "US",
            "telephone_number": "248-686-4844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JIDDOU",
        "first_name": "SERENA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "258297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kisha Jean
• Salnave Jean, M. ED.
• Grace Eunhye Jeong, O.D.
• Thatiana Jeune, CNP
• Haixia Jia, M.D.
• John T. Tieu D.M.D, P.C. (Smile Group Dental)
• Kaniesha Johnson-Palmer
• Khai-El Johnson, M.D.
• Natasha Johnson, LPN
• Nicole Johnson, RN

• Emergency Medicine Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2019; 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.