Active NPI
Michael Serwacki
- Pediatric Cardiology Physician
- Fort Sam Houston, TX
National Provider Identifier
1841264785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 7444
- Practice address
- 3551 Roger Brooke Dr
Brooke Army Medical Center
Fort Sam Houston, TX 78234 - Phone
- (210) 916-4129
- Fax
- (210) 916-5456
- NPI assigned
- Feb 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 7444 | MT | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Brooke Army Medical Center
Fort Sam Houston, TX 78234
Mailing address
3551 Roger Brooke Dr
Brooke Army Medical Center
Fort Sam Houston, TX 78234
Phone (210) 916-4129
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1841264785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"address_2": "BROOKE ARMY MEDICAL CENTER",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "78234",
"telephone_number": "210-916-4129",
"fax_number": "210-916-5456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"address_2": "BROOKE ARMY MEDICAL CENTER",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "78234",
"telephone_number": "210-916-4129",
"fax_number": "210-916-5456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERWACKI",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-16",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "MT",
"license": "7444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.