NPIMap

Individual provider Active NPI

Serda C Hawthorne, MD

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1659507986
Registry record updated Mar 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME116450 Issued in FL
Practice address
1190 E Nine Mile Rd
Pensacola, FL 32514-1651
Phone
(850) 857-4040
Fax
(850) 479-9180
NPI assigned
Jun 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A105621 CA
Family Medicine Physician 207Q00000X ME116450 FL Primary

Addresses

Primary practice location

1190 E Nine Mile Rd
Pensacola, FL 32514-1651

Mailing address

9527 Laramie Dr
Pensacola, FL 32506-7876
Phone (850) 857-4040

Other names 1

  • Serda Carolin Gurses Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140408001284 FL Practitioner - Family Practice 5890841134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pensacola Primary Care IncGroup PAC ID 6002718343, 21 clinicians

Practice addresses (Care Compare)

1190 E Nine Mile Rd
West Florida Primary Care Nine Mi
Pensacola, FL 32514-1651
Phone (850) 857-4040

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Pensacola, FL, CCN 107792
  • Amedisys Home Health Home health agency, Pensacola, FL, CCN 108309
  • Vitas Healthcare Corporation of Florida Hospice, Melbourne, FL, CCN 101545
  • HCA Florida West Hospital Hospital, Pensacola, FL, CCN 100231
  • Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
  • Baptist Hospital Hospital, Pensacola, FL, CCN 100093
  • Jay Hospital Hospital, Jay, FL, CCN 101315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME116450FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pensacola Primary Care Inc Family Medicine CurrentSince Mar 4, 2014 Accepting new patients
Pensacola Primary Care Inc Family Medicine CurrentSince Mar 4, 2014 Accepting new patients
Providence Facey Medical Foundation Family Medicine Past Accepting new patients
Providence Facey Medical Foundation Past Accepting new patients
Pensacola Primary Care, Inc. Past Accepting new patients

Locations

1190 E Nine Mile Rd
Pensacola, FL 32514
Phone (850) 474-8771

8333 N Davis Hwy
Pensacola, FL 32514
Phone (850) 474-8000

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: serda.hawthorne@hca5.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 10

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": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1659507986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9527 LARAMIE DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325067876",
            "telephone_number": "850-857-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E NINE MILE RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325141651",
            "telephone_number": "850-857-4040",
            "fax_number": "850-479-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWTHORNE",
        "first_name": "SERDA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A105621",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME116450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERDA",
            "last_name": "GURSES",
            "middle_name": "CAROLIN",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.