Active NPI
Sandy Serna, MD
- Family Medicine Physician
- San Juan Capistrano, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A178739
- Practice address
- 31001 Rancho Viejo Road, Ste. 200
San Juan Capistrano, CA 92675 - Phone
- (949) 661-9600
- Fax
- (949) 443-6200
- NPI assigned
- Apr 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A178739 | CA | Primary |
Addresses
Primary practice location
31001 Rancho Viejo Road, Ste. 200
San Juan Capistrano, CA 92675
Mailing address
31001 Rancho Viejo Road, Ste. 200
San Juan Capistrano, CA 92675
Phone (949) 661-9600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93274379F05357 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://memorialcare.org/fhir/api/FHIR/R4/ | Health Information Exchange (HIE) | MemorialCare Medical Foundation |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
31001 Rancho Viejo Rd
Suite 200
San Juan Capistrano, CA 92675-8704
Phone (949) 661-9611
Hospital & facility affiliations
- Memorialcare Saddleback Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A178739 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Family Medicine | Current | Accepting new patients |
| Bristol Park Medical Group, Inc | Family Medicine | Past | Accepting new patients |
| Sutter Valley Hospitals | Past | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
31001 Rancho Viejo Rd
Ste 200
San Juan Capistrano, CA 92675
Phone (949) 661-9600
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- sserna747237@direct.memorialcare.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Costa Mesa, CA
- NPI 1043266760
-
- General Acute Care Hospital
- Modesto, CA
- NPI 1699129601
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Laguna Hills, CA
- NPI 1275576381
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660780800000",
"number": "1659834620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31001 RANCHO VIEJO ROAD, STE. 200",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "92675",
"telephone_number": "949-661-9600",
"fax_number": "949-443-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31001 RANCHO VIEJO ROAD, STE. 200",
"city": "SAN JUAN CAPISTRANO",
"state": "CA",
"postal_code": "92675",
"telephone_number": "949-661-9600",
"fax_number": "949-443-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERNA",
"first_name": "SANDY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-08",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A178739",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "93274379F05357",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
"affiliation": "Y",
"endpointDescription": "MemorialCare FHIR Endpoint",
"affiliationName": "MemorialCare Medical Foundation",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "17360 Brookhurst St",
"city": "Fountain Valley",
"state": "CA",
"country_code": "US",
"postal_code": "927083720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Juan Capistrano, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.