Individual provider Active NPI

Serena Grace Borrero Lovelace, NP, RN

  • Nurse Practitioner
  • Stony Brook, NY
National Provider Identifier
1679163729
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3538413 Issued in NY
Practice address
101 Nicolls Rd
Stony Brook, NY 11794-3810
Phone
(631) 444-0580
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3538413 NY Primary
Registered Nurse 163W00000X RN9551847 FL
Registered Nurse 163W00000X 741684 NY

Addresses

Primary practice location

101 Nicolls Rd
Stony Brook, NY 11794-3810

Mailing address

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

Other names 1

  • Serena Borrero Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Serena.borrero@direct.stonybrookmedicine.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722001619 NY Practitioner - Nurse Practitioner 7810433281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-1750

101 Nicolls Rd
Stony Brook, NY 11794-0001
Phone (631) 444-0580

301 E Main St
Bay Shore, NY 11706-8408
Phone (631) 941-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9551847FLMDRegistered Nurse
741684NYMDRegistered Nurse
3538413NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Internists, University Faculty Practice Corporation CurrentSince Jul 11, 2024 Accepting new patients

Locations

301 Montauk Hwy
Bay Shore, NY 11706
Phone (631) 630-3977

101 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-2065

100 Nicolls Rd
Stony Brook, NY 11794
Phone (631) 444-1560

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: serena.borrero@direct.stonybrookmedicine.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1679163729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117940001",
            "telephone_number": "631-444-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117943810",
            "telephone_number": "631-444-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORRERO LOVELACE",
        "first_name": "SERENA",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "NP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "3538413",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9551847",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "741684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Serena.borrero@direct.stonybrookmedicine.edu",
            "affiliation": "N",
            "address_1": "101 Nicolls Rd",
            "city": "Stony Brook",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117943810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SERENA",
            "last_name": "BORRERO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.