Individual provider Active NPI

Serjun Castro Andaya, MD

  • Neonatal-Perinatal Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1568588952
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
ME 123354 Issued in FL
Practice address
215 Grand Ave
Coral Gables, FL 33133-4841
Phone
(305) 441-7179
Fax
(305) 448-7134
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 13958 NV
Neonatal-Perinatal Medicine Physician 2080N0001X ME 123354 FL Primary

Addresses

Primary practice location

215 Grand Ave
Coral Gables, FL 33133-4841

Mailing address

2263 SW 37TH Ave
#433
Miami, FL 33145-3275
Phone (213) 675-0129

Other identifiers 1

IdentifierTypeStateIssuer
LL1556OtherNVMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111215000802 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9739354952

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 123354FLMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Hospital Past Accepting new patients
Pokroy Medical Group of Nevada, LTD. Neonatal-Perinatal Medicine Past Accepting new patients
South Dade Neonatology Neonatal-Perinatal Medicine Past Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

Organizations & group practices 5

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568588952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 SW 37TH AVE",
            "address_2": "#433",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331453275",
            "telephone_number": "213-675-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 GRAND AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331334841",
            "telephone_number": "305-441-7179",
            "fax_number": "305-448-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDAYA",
        "first_name": "SERJUN",
        "middle_name": "CASTRO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NV",
            "license": "13958",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "FL",
            "license": "ME 123354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "LL1556",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.