Individual provider Active NPI

Priscilla Anne Serrano, PA

  • Physician Assistant
  • Virginia Beach, VA
National Provider Identifier
1881627347
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001354 Issued in VA
Practice address
5226 Indian River Rd
Suite 102
Virginia Beach, VA 23464-6179
Phone
(757) 216-4030
Fax
(757) 216-4029
NPI assigned
Jul 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001354 VA Primary

Addresses

Primary practice location

5226 Indian River Rd
Suite 102
Virginia Beach, VA 23464-6179

Mailing address

5226 Indian River Rd
Suite 102
Virginia Beach, VA 23464-6179
Phone (757) 216-4030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060720000204 VA Practitioner - Physician Assistant 4082627849 Reassigns benefits to 1 organization
I20130925000588 DC Practitioner - Physician Assistant 4082627849 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110001354VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Feb 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Feb 1, 2019 Accepting new patients
Inova Health Care Services CurrentSince Feb 1, 2019 Accepting new patients
Loudoun Anesthesia/Loudoun Interventional Pain Center Past Accepting new patients
Loudoun Anesthesia Associates Past Accepting new patients

Locations

3300 Gallows Rd
Fl 1
Falls Church, VA 22042
Phone (703) 776-4005

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

4 Pidgeon Hill Dr
Sterling, VA 20165
Phone (703) 433-9230

14605 Potomac Branch Dr
Ste 100
Woodbridge, VA 22191
Phone (703) 738-4371

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1881627347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5226 INDIAN RIVER RD",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646179",
            "telephone_number": "757-216-4030",
            "fax_number": "757-216-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5226 INDIAN RIVER RD",
            "address_2": "SUITE 102",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646179",
            "telephone_number": "757-216-4030",
            "fax_number": "757-216-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "PRISCILLA",
        "middle_name": "ANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.