Individual provider Active NPI

Tricia Scerba

  • Pediatrics Physician
  • Decatur, IL
National Provider Identifier
1467534065
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036100229 Issued in IL
Practice address
320 E Central Ave
Decatur, IL 62521-4665
Phone
(217) 877-9117
Fax
(217) 877-3082
NPI assigned
Oct 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036100229 IL Primary

Addresses

Primary practice location

320 E Central Ave
Decatur, IL 62521-4665

Mailing address

320 E Central Ave
Decatur, IL 62521-4665
Phone (217) 877-9117

Other identifiers 1

IdentifierTypeStateIssuer
036100229MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040406000377 IL Practitioner - Pediatric Medicine 7618960683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Improvement CenterGroup PAC ID 4385625342, 13 clinicians

Practice addresses (Care Compare)

320 E Central Ave
Decatur, IL 62521-4665
Phone (217) 877-9117

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Improvement Center CurrentSince Mar 5, 2016 Accepting new patients
Community Health Improvement Center Current Accepting new patients
Community Health Improvement Center CurrentSince Mar 5, 2016 Accepting new patients
Dewitt County Human Resource Center PastSince Sep 1, 2009 Accepting new patients
Community Health Improvement Center Past Accepting new patients
Dewitt-Piatt Bi-County Health Department PastSince Jun 30, 2014 Accepting new patients

Locations

320 E Central Ave
Decatur, IL 62521
Phone (217) 877-4694

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

Interoperability endpoints

  • Direct secure messaging: tricia.scerba.p31@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1467534065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E CENTRAL AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214665",
            "telephone_number": "217-877-9117",
            "fax_number": "217-877-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E CENTRAL AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214665",
            "telephone_number": "217-877-9117",
            "fax_number": "217-877-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCERBA",
        "first_name": "TRICIA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036100229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100229",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.