NPIMap

Organization Active NPI

Serenagroup Professional Services, P.C.

  • Multi-Specialty Clinic/Center
  • Akron, OH
National Provider Identifier
1568816965
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SERENAGROUP PROFESSIONAL SERVICES, P.C.
Practice address
1 Akron General Ave
Akron, OH 44307-2432
Phone
(330) 344-5760
NPI assigned
Apr 21, 2016
Last updated
Aug 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SERENAGROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Authorized official

Name
Blair Flinn, MHA
Title
VP of Professional Services
Phone
(913) 426-4995

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician 207PE0005X
Vascular Surgery Physician 2086S0129X 228580 MA

Addresses

Primary practice location

1 Akron General Ave
Akron, OH 44307-2432

Mailing address

PO Box 791
Carnegie, PA 15106-0791
Phone (412) 655-4362

Other practice location 1

4318 Northern Pike Ste 201
Monroeville, PA 15146-2824
Phone (724) 699-6698

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, SC, PA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20170125002673 OH Part B Supplier - Clinic/Group Practice 4486947413 Receives reassigned benefits from 3 practitioners
Practice locations: Akron, OH
O20180702002011 SC Part B Supplier - Clinic/Group Practice 4486947413 Receives reassigned benefits from 1 practitioner
Practice locations: Orangeburg, SC
O20220127002088 PA Part B Supplier - Clinic/Group Practice 4486947413 Receives reassigned benefits from 7 practitioners
Practice locations: Monroeville, PA

National Provider Directory

National Provider Directory

Locations

719 E Airport Ave
Baton Rouge, LA 70806
Phone (225) 924-5251

175 Derby St
Ste 2
Hingham, MA 02043
Phone (781) 749-9227

7710 Mercy Rd
Ste 509
Omaha, NE 68124
Phone (402) 398-5500

1 Akron General Ave
Ste 1603
Akron, OH 44307

4318 Northern Pike
Ste 201
Monroeville, PA 15146
Phone (412) 212-0123

2700 Research Forest Dr
The Woodlands, TX 77381

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629417600000",
    "number": "1568816965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "CARNEGIE",
            "state": "PA",
            "postal_code": "151060791",
            "telephone_number": "412-655-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432",
            "telephone_number": "330-344-5760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4318 Northern Pike Ste 201",
            "address_purpose": "LOCATION",
            "city": "Monroeville",
            "state": "PA",
            "postal_code": "151462824",
            "country_code": "US",
            "telephone_number": "724-699-6698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SERENAGROUP PROFESSIONAL SERVICES, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERENAGROUP, INC",
        "enumeration_date": "2016-04-21",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "FLINN",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_title_or_position": "VP OF PROFESSIONAL SERVICES",
        "authorized_official_telephone_number": "913-426-4995",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207PE0005X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "228580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.