NPIMap

Organization Active NPI

Serendib Healthways, Inc

  • Family Medicine Physician
  • Van Nuys, CA
National Provider Identifier
1447503974
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SERENDIB HEALTHWAYS, INC
Doing business as
Serendib Healthways
Practice address
14608 Victory Blvd
Van Nuys, CA 91411-1621
Phone
(818) 786-7710
Fax
(818) 786-7711
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Dr. Janesri W De Silva, M.DNPI 1568502953
Title
President/Medical Director
Phone
(818) 786-7710

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A88991 CA
Health Maintenance Organization 302R00000X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

14608 Victory Blvd
Van Nuys, CA 91411-1621

Mailing address

18543 Devonshire St
Suite 435
Northridge, CA 91324-1308
Phone (818) 786-7710

Other identifiers 1

IdentifierTypeStateIssuer
A88991MedicaidCA

Other names 1

  • Serendib Healthways Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Serendib Healthways2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1447503974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18543 DEVONSHIRE ST",
            "address_2": "SUITE 435",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241308",
            "telephone_number": "818-786-7710",
            "fax_number": "818-786-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14608 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-786-7710",
            "fax_number": "818-786-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIB HEALTHWAYS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "DE SILVA",
        "authorized_official_first_name": "JANESRI",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-786-7710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88991",
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A88991",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serendib Healthways",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.