Amanda Brooke Sergay, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME114062 Issued in FL

Practice address

3216 W Azeele St Ste 1
Tampa, FL 33609-3018

Phone

(813) 738-5660

Fax

(813) 738-5661

NPI assigned

Dec 9, 2007

Last updated

Nov 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 20, 2021 through Aug 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1197158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1730362112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 W AZEELE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093018",
            "telephone_number": "917-309-3019",
            "fax_number": "813-738-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 W AZEELE ST STE 1",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093018",
            "telephone_number": "813-738-5660",
            "fax_number": "813-738-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGAY",
        "first_name": "AMANDA",
        "middle_name": "BROOKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-09",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME114062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Mental Health Specialists LLC
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• Serenity Thoughts LLC
• Serenity Village Inc
• Stephen M Sergay, MD
• Leslie Ann Serge
• Sergio J. Jacinto, M.D., P.a.
• Sergio M. Lopez, D.D.S.,P. L.L.C.
• C Christopher Sergio, CRNA

• Dermatology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.