Individual provider Active NPI

Robyn Sera, NP

  • Primary Care Nurse Practitioner
  • Oakland, CA
National Provider Identifier
1720305600
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
661634 Issued in CA
Practice address
10700 Macarthur Blvd
Suite 14B
Oakland, CA 94605-5298
Phone
(510) 563-4300
Fax
(510) 563-4384
NPI assigned
Apr 30, 2010
Last updated
Mar 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 661634 CA Primary

Addresses

Primary practice location

10700 Macarthur Blvd
Suite 14B
Oakland, CA 94605-5298

Mailing address

2344 6TH Street
Attention: Credentialing Dept.
Berkeley, CA 94710
Phone (510) 563-4300

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
I20111017000320 CA Order and Referring Only - Nurse Practitioner 1557533593

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
661634CAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1720305600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2344 6TH STREET",
            "address_2": "ATTENTION: CREDENTIALING DEPT.",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94710",
            "telephone_number": "510-563-4300",
            "fax_number": "510-553-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 MACARTHUR BLVD",
            "address_2": "SUITE 14B",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946055298",
            "telephone_number": "510-563-4300",
            "fax_number": "510-563-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERA",
        "first_name": "ROBYN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "661634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.