Organization Active NPI

Thomas G Serio MD PA

  • Primary Care Clinic/Center
  • Tallahassee, FL
National Provider Identifier
1750540217
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
THOMAS G SERIO MD PA
Practice address
1802 Miccosukee Commons Dr
Tallahassee, FL 32308-5432
Phone
(850) 656-5411
Fax
(850) 656-5611
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Dr. Thomas G Serio, MDNPI 1184654055
Title
President
Phone
(850) 656-5411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1802 Miccosukee Commons Dr
Tallahassee, FL 32308-5432

Mailing address

1802 Miccosukee Commons Dr
Tallahassee, FL 32308-5432
Phone (850) 656-5411

Other identifiers 1

IdentifierTypeStateIssuer
377627100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090128000304 FL Part B Supplier - Clinic/Group Practice 5193889699 Receives reassigned benefits from 1 practitioner
Practice locations: Tallahassee, FL

National Provider Directory

National Provider Directory

Locations

1802 Miccosukee Commons Dr
Tallahassee, FL 32308
Phone (850) 576-3847

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1750540217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 MICCOSUKEE COMMONS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085432",
            "telephone_number": "850-656-5411",
            "fax_number": "850-656-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 MICCOSUKEE COMMONS DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085432",
            "telephone_number": "850-656-5411",
            "fax_number": "850-656-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS G SERIO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "SERIO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-656-5411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377627100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.