Individual provider Active NPI

Jacklyn Marie Serrano, APRN

  • Nurse Practitioner
  • New York, NY
National Provider Identifier
1861340598
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11040579 Issued in FL
Practice address
169 Madison Ave
New York, NY 10016-5101
Phone
(917) 626-6222
NPI assigned
Mar 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11040579 FL Primary

Addresses

Primary practice location

169 Madison Ave
New York, NY 10016-5101

Mailing address

19261 SW 190TH St
Miami, FL 33187-1906
Phone (786) 285-5204

Other practice location 1

100460 Overseas Hwy
Key Largo, FL 33037-2547
Phone (305) 294-0011 ext. 2

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11040579FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1773792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1861340598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19261 SW 190TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331871906",
            "telephone_number": "786-285-5204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MADISON AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165101",
            "telephone_number": "917-626-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100460 Overseas Hwy",
            "address_purpose": "LOCATION",
            "city": "Key Largo",
            "state": "FL",
            "postal_code": "330372547",
            "country_code": "US",
            "telephone_number": "305-294-0011 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "JACKLYN",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-18",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11040579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.