Individual provider Active NPI

Kay Kazuko Sera, D.C., L.AC.

  • Chiropractor
  • Montebello, CA
National Provider Identifier
1649340266
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC19356 Issued in CA
Practice address
1625 Paramount Blvd
Montebello, CA 90640-2133
Phone
(626) 571-7404
Fax
(626) 571-7412
NPI assigned
Nov 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC10648 CA
Chiropractor 111N00000X DC19356 CA Primary

Addresses

Primary practice location

1625 Paramount Blvd
Montebello, CA 90640-2133

Mailing address

1625 Paramount Blvd
Montebello, CA 90640-2133
Phone (626) 571-7404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100913000818 CA Practitioner - Chiropractic 7517082696 Practice locations: Rosemead, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1320 -2 Potrero Grande Dr
South San Gabriel, CA 91770-4154

1320 /2 Potrero Grande Dr
Rosemead, CA 91770-4154
Phone (626) 571-7404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC19356CAMDChiropractor
AC10648CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1649340266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 PARAMOUNT BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402133",
            "telephone_number": "626-571-7404",
            "fax_number": "626-571-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 PARAMOUNT BLVD",
            "city": "MONTEBELLO",
            "state": "CA",
            "postal_code": "906402133",
            "telephone_number": "626-571-7404",
            "fax_number": "626-571-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERA",
        "first_name": "KAY",
        "middle_name": "KAZUKO",
        "name_prefix": "Dr.",
        "credential": "D.C., L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC10648",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC19356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montebello, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.