Individual provider Active NPI

Serena Shong, NP

  • Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1700902921
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP16218 Issued in CA
Practice address
2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680
Phone
(408) 769-4323
NPI assigned
Mar 21, 2007
Last updated
Dec 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP16218 CA Primary
Women's Health Nurse Practitioner 363LW0102X RN513146 CA

Addresses

Primary practice location

2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680

Mailing address

2400 Moorpark Ave Ste 300
San Jose, CA 95128-2680
Phone (408) 769-4323

Other names 1

  • Ms. Serena Roslyn Ho Other name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161223000272 CA Practitioner - Nurse Practitioner 7416238829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 Centerview Dr
Suite 250
Brentwood, TN 37027-2700

2171 Junipero Serra Blvd
Suite 260
Daly City, CA 94014-1906

22330 Homestead Rd
Apt 113
Cupertino, CA 95014-0130

22330 Homestead Rd
Apt 113
Cupertino, CA 95014-0131

2350 W El Camino Real
FL 2
Mountain View, CA 94040-6203

PO Box
Suite 5478
Pawtucket, RI 02862

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP16218CAMDNurse Practitioner
RN513146CAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Dec 3, 2025 Accepting new patients
Asian Americans for Community Involvement of Santa Clara County, Inc CurrentSince Dec 3, 2025 Accepting new patients

Locations

2400 Moorpark Ave
Ste 300
San Jose, CA 95128
Phone (408) 975-2763

266 N Jackson Ave
Ste 4
San Jose, CA 95116
Phone (408) 975-2763

Interoperability endpoints

  • Direct secure messaging: sshong18818@northeastmedicalservicesnems.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1700902921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282680",
            "telephone_number": "408-769-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MOORPARK AVE STE 300",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282680",
            "telephone_number": "408-769-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHONG",
        "first_name": "SERENA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP16218",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "RN513146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERENA",
            "last_name": "HO",
            "middle_name": "ROSLYN",
            "prefix": "MS.",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.