Individual provider Active NPI

Mary Susan Monserate Serana, BSN RN

  • Registered Nurse
  • Bethpage, NY
National Provider Identifier
1568728566
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
7092895 Issued in NY
Practice address
3929 Berger Ave
Bethpage, NY 11714-5001
Phone
(516) 263-4447
Fax
(516) 520-0121
NPI assigned
Apr 4, 2012
Last updated
Apr 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 7092895 NY Primary

Addresses

Primary practice location

3929 Berger Ave
Bethpage, NY 11714-5001

Mailing address

3929 Berger Ave
Bethpage, NY 11714-5001
Phone (516) 263-4447

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)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
7092895NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1568728566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 BERGER AVE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145001",
            "telephone_number": "516-263-4447",
            "fax_number": "516-520-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 BERGER AVE",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145001",
            "telephone_number": "516-263-4447",
            "fax_number": "516-520-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERANA",
        "first_name": "MARY SUSAN",
        "middle_name": "MONSERATE",
        "credential": "BSN RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "7092895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.