Individual provider Active NPI

Ricardo A Serrano, MD

  • Adult Medicine Physician
  • Merritt Island, FL
National Provider Identifier
1629180351
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME0069902 Issued in FL
Practice address
30 Fortenberry Rd
Merritt Island, FL 32952-3616
Phone
(321) 453-2267
Fax
(321) 453-8019
NPI assigned
Aug 31, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME0069902 FL Primary

Addresses

Primary practice location

30 Fortenberry Rd
Merritt Island, FL 32952-3616

Mailing address

30 Fortenberry Rd
Merritt Island, FL 32952
Phone (321) 453-2267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20040405000985 FL Practitioner - Family Practice 9931192358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30 Fortenberry Rd
Merritt Island, FL 32952-3616
Phone (321) 453-2231

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0069902FLMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ricardo a Serrano MD LLC Adult Medicine CurrentSince Jan 1, 2004 Accepting new patients

Locations

30 Fortenberry Rd
Merritt Island, FL 32952
Phone (321) 453-2267

110 Longwood Ave
Rockledge, FL 32955
Phone (321) 452-9799

Interoperability endpoints

  • Direct secure messaging: ricardo.serrano.2@29686.direct.athenahealth.com
  • Direct secure messaging: rserrano71602@epicdirect.hf.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1629180351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 FORTENBERRY RD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "32952",
            "telephone_number": "321-453-2267",
            "fax_number": "321-453-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 FORTENBERRY RD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523616",
            "telephone_number": "321-453-2267",
            "fax_number": "321-453-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "RICARDO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME0069902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merritt Island, FL

Sources for this page

Verify at the official NPI Registry.