NPIMap

Individual provider Active NPI

Lourdes Delgado-Serrano, MD

  • Child & Adolescent Psychiatry Physician
  • Peoria, IL
National Provider Identifier
1508834839
Registry record updated Feb 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
036083077 Issued in IL
Practice address
Dept of Pediatrics
320 E Armstrong
Peoria, IL 61603
Phone
(309) 624-9587
NPI assigned
Mar 11, 2006
Last updated
Feb 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X 036083077 IL Primary

Addresses

Primary practice location

Dept of Pediatrics
320 E Armstrong
Peoria, IL 61603

Mailing address

1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-8503

Other names 1

  • Lourdes Serrano Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080108000902 IL Practitioner - Psychiatry 2365522935 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Puerto Rico School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-3173

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Nov 1, 2007 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Nov 1, 2007 Accepting new patients
Bridgeway Inc CurrentSince Oct 16, 2002 Accepting new patients
Bridgeway Inc Child & Adolescent Psychiatry CurrentSince Oct 16, 2002 Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients
Bridgeway Inc. Past Accepting new patients
University of Illinois Past Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

2323 Windish Dr
Galesburg, IL 61401
Phone (309) 344-2323

137 E College St
Kewanee, IL 61443
Phone (309) 852-4331

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

320 E Armstrong Ave
Peoria, IL 61603
Phone (309) 624-9587

507 E Armstrong Ave
Peoria, IL 61603
Phone (309) 681-6960

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1508834839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ILLINI DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616052576",
            "telephone_number": "309-671-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPT OF PEDIATRICS",
            "address_2": "320 E ARMSTRONG",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61603",
            "telephone_number": "309-624-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO-SERRANO",
        "first_name": "LOURDES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-11",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036083077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOURDES",
            "last_name": "SERRANO",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.