Individual provider Active NPI

Jasna Seserinac, M.D.

  • Pediatrics Physician
  • Tucson, AZ
National Provider Identifier
1497785208
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33299 Issued in AZ
Practice address
1501 N Campbell Avenue
Tucson, AZ 85724
Phone
(520) 626-6614
Fax
(520) 626-2883
NPI assigned
Jul 4, 2006
Last updated
May 29, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-093075 IL
Pediatrics Physician 208000000X 33299 AZ Primary

Addresses

Primary practice location

1501 N Campbell Avenue
Tucson, AZ 85724

Mailing address

2701 E Elvira Rd
Tucson, AZ 85756-7124
Phone (520) 626-6614

Other identifiers 1

IdentifierTypeStateIssuer
181641MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20080221000605 AZ Practitioner - Pediatric Medicine 4981788486 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-093075ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
District Medical Group, Inc CurrentSince Jan 1, 2023 Accepting new patients
District Medical Group, Inc Current Accepting new patients
District Medical Group, Inc CurrentSince Jan 1, 2023 Accepting new patients
Maricopa County Special Health Care District Past Accepting new patients

Locations

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

2601 E Roosevelt St
Ste 0D10
Phoenix, AZ 85008

3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520

Interoperability endpoints

  • Direct secure messaging: jseserinac251605@direct.valleywisehealth.org

Organizations & group practices 4

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1497785208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E ELVIRA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857567124",
            "telephone_number": "520-626-6614",
            "fax_number": "520-626-2883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N CAMPBELL AVENUE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85724",
            "telephone_number": "520-626-6614",
            "fax_number": "520-626-2883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESERINAC",
        "first_name": "JASNA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-093075",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181641",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.