Kerian Service, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

049742 Issued in CT

Practice address

150 N Main St
Manchester, CT 06042-2003

Phone

(860) 528-1359

Fax

(860) 290-4142

NPI assigned

Jun 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Family Practice

Education

New York Medical College, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Middlesex Hospital Hospital, Middletown, CT, CCN 070020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kerian.service@chcict.eclinicaldirectplus.com

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.

• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1952591851

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Danbury, CT
  • NPI 1003332446
  NPD
• Community Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Middletown, CT
  • NPI 1164463840

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Middlesex Hospital

  • General Acute Care Hospital
  • Middletown, CT
  • NPI 1760454334
  Care Compare affiliation

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1598925612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 CONNECTICUT BLVD",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083013",
            "telephone_number": "860-528-1359",
            "fax_number": "860-290-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422003",
            "telephone_number": "860-528-1359",
            "fax_number": "860-290-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVICE",
        "first_name": "KERIAN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "049742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007228810",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serge P. Poulin, MD
• Serge P. Poulin, MD
• Alyssa Marie Serra
• Katarina Serrano
• Sean Serrano, LMSW
• Kylan Seville
• Michelle Seville
• Abid Shah, DPT, PT
• Dinesh S. Shah, M.D.
• Nikitaben Jagjivandas Shah, PHARMD

• Family Medicine Physician in Manchester, CT
• Providers in Manchester, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.