NPIMap

Organization Active NPI

Serendib Healthways, Inc

Doing business as Serendib Healthways

  • General Practice Physician
  • Van Nuys, CA
National Provider Identifier
1902166721
Registry record updated May 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A889910 Issued in CA
Legal business name
SERENDIB HEALTHWAYS, INC
Doing business as
Serendib Healthways
Practice address
14608 Victory Blvd
Van Nuys, CA 91411-1621
Phone
(818) 786-7710
Fax
(818) 786-7711
NPI assigned
May 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2012

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

Authorized official

Name
Dr. Janesri W De Silva, M.D.NPI 1568502953
Title
President
Phone
(818) 305-3755

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X A889910 CA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A889910 CA Primary

Addresses

Primary practice location

14608 Victory Blvd
Van Nuys, CA 91411-1621

Mailing address

18543 Devonshire St
Suite 435
Northridge, CA 91324-1308
Phone (818) 786-7710

Other identifiers 1

IdentifierTypeStateIssuer
A889910OtherCAMEDICAL LICENSE

Other names 1

  • SERENDIB HEALTHWAYS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Serendib Healthways2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14608 Victory Blvd
Van Nuys, CA 91411
Phone (818) 786-7710

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": "1337990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337990400000",
    "number": "1902166721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18543 DEVONSHIRE ST",
            "address_2": "SUITE 435",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241308",
            "telephone_number": "818-786-7710",
            "fax_number": "818-786-7711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14608 VICTORY BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111621",
            "telephone_number": "818-786-7710",
            "fax_number": "818-786-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIB HEALTHWAYS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-26",
        "last_updated": "2012-05-26",
        "status": "A",
        "authorized_official_last_name": "DE SILVA",
        "authorized_official_first_name": "JANESRI",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-305-3755",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A889910",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A889910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A889910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SERENDIB HEALTHWAYS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2012; 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.