Individual provider Active NPI

Rukhsana Serang, D.O.

  • Family Medicine Physician
  • Tustin, CA
National Provider Identifier
1780023754
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A14122 Issued in CA
Practice address
15000 Kensington Park Dr Ste 250
Tustin, CA 92782-1835
Phone
(714) 477-8320
NPI assigned
Jun 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A14122 CA Primary

Addresses

Primary practice location

15000 Kensington Park Dr Ste 250
Tustin, CA 92782-1835

Mailing address

15000 Kensington Park Dr Ste 250
Tustin, CA 92782-1835

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160811002798 CA Practitioner - Family Practice 4981998051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Western University of Health Sciences College of Dental Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hoag ClinicGroup PAC ID 3274872064, 447 clinicians

Practice addresses (Care Compare)

8970 Warner Ave
Fountain Valley, CA 92708-3211
Phone (714) 477-8400

Hospital & facility affiliations

  • Hoag Memorial Hospital Presbyterian Hospital, Newport Beach, CA, CCN 050224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
14122CAMDAcupuncturist
20A14122CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hoag Clinic CurrentSince Mar 1, 2019 Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Hoag Hospital Past Accepting new patients

Locations

8970 Warner Ave
Fountain Vly, CA 92708
Phone (714) 477-8400

1031 Avenida Pico
Ste 204
San Clemente, CA 92673
Phone (949) 829-5533

15000 Kensington Park Dr
Ste 250
Tustin, CA 92782
Phone (714) 477-8320

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10944/brand/3/csg/1/fhir/r4
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 and National Provider Directory roles.

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": "1371859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1780023754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR STE 250",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15000 KENSINGTON PARK DR STE 250",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927821835",
            "telephone_number": "714-477-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERANG",
        "first_name": "RUKHSANA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-22",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.