Active NPI
Chris H Serlo, D.P.M.
- Foot Surgery Podiatrist
- Rockville, MD
National Provider Identifier
1538228549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 00638
- Practice address
- 15201 Shady Grove Rd
Suite 102
Rockville, MD 20850-3217 - Phone
- (301) 921-0009
- Fax
- (301) 921-0019
- NPI assigned
- Dec 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 00638 | MD | Primary |
Addresses
Primary practice location
15201 Shady Grove Rd
Suite 102
Rockville, MD 20850-3217
Mailing address
15201 Shady Grove Rd
Suite 102
Rockville, MD 20850-3217
Phone (301) 921-0009
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| T289 | Other | MD | CAREFIRST BCBS |
| 34050-8700 | Medicaid | MD | |
| 4243656 | Other | AETNA PPO | |
| 2300969 | Other | AETNA HMO | |
| 52-1346837 | Other | TAX ID# | |
| 21651 | Other | MDIPA OPTIMUM CHOICE | |
| 6387 | Other | DC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00638 | MD | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245888000000",
"number": "1538228549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15201 SHADY GROVE RD",
"address_2": "SUITE 102",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503217",
"telephone_number": "301-921-0009",
"fax_number": "301-921-0019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15201 SHADY GROVE RD",
"address_2": "SUITE 102",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208503217",
"telephone_number": "301-921-0009",
"fax_number": "301-921-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERLO",
"first_name": "CHRIS",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2009-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "MD",
"license": "00638",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BCBS",
"identifier": "T289",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34050-8700",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO",
"identifier": "4243656",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2300969",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID#",
"identifier": "52-1346837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA OPTIMUM CHOICE",
"identifier": "21651",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "6387",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.