Serenity Bay Health PLLC

Organization Active NPI Psychiatry Physician · Auburn, MI

NPI 1497320451 · NPPES record last updated Sep 11, 2021

Key facts

NPI
1497320451
Entity type
Organization (NPI type 2)
Primary specialty
Psychiatry Physician 2084P0800X
Legal business name
SERENITY BAY HEALTH PLLC
Practice address
946 W Midland Rd
Auburn, MI 48611-9400
Phone
(989) 266-3188
Fax
(949) 561-5532
NPI assigned
May 23, 2021
Organization subpart
No

Authorized official

Name
Dr. Adam David Nicholas, MD NPI 1033309950
Title
Psychiatrist
Phone
(989) 266-3188

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

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

Practitioners 23

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210615002306 MI Part B Supplier - Clinic/Group Practice 3577963404 Receives reassigned benefits from 20 practitioners
Practice locations: Auburn, MI; Bay City, MI

National Provider Directory

Tax ID family
Serenity Bay Health PLLC (2 organizations share this tax ID)

Locations

946 W Midland Rd
Auburn, MI 48611
Phone (989) 266-3188

1426 Straits Dr
#B
Bay City, MI 48706

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2084P0800X Yes

Addresses

Primary practice location

946 W Midland Rd
Auburn, MI 48611-9400

Mailing address

946 W Midland Rd
Auburn, MI 48611-9400
Phone (989) 266-3188

Other providers in Auburn, MI

All providers in Auburn, MI · Psychiatry Physician in Michigan

Sources for this page

Verify at the official NPI Registry.