Lica Sert

Primary specialty

EEG Specialist/TechnologistTaxonomy code 246ZE0500X

Practice address

806 S 56TH Ave Ste 1B
Phoenix, AZ 85043-4630

Phone

(602) 429-0447

NPI assigned

Sep 15, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Functional Medicine Center of Arizona

  • Health & Wellness Coach
  • Phoenix, AZ
  • NPI 1235870205
  NPD
• Psychiatric Centers at San Diego, Inc. Med GRP

  • Mental Health Counselor
  • San Diego, CA
  • NPI 1841241585
  NPD (past)

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1669920849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 S 56TH AVE STE 1B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850434630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 S 56TH AVE STE 1B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850434630",
            "telephone_number": "602-429-0447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERT",
        "first_name": "LICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-15",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "neuro@elite2p.com",
            "affiliation": "N",
            "address_1": "806 S 56th Ave Ste 1B",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850434630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Serrano, FNP
• Lawrence Pierre Serrano, MD
• Martha Serrano, PMHNP
• Sophia Samantha Abigail Serrano, LCSW
• Hector Serrato, ED.S., NCSP
• Service First Physical Therapy, LLC
• Serving Hands LLC
• Kendahl Servino, MD
• Elizabeth Sesmas
• Maya Isabella Sesmas

• Other Specialist/Technologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Other Specialist/Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.