David J Serra, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

223702 Issued in NY

Practice address

2950 Elmwood Ave
Kenmore, NY 14217-1304

Phone

(716) 649-0887

Fax

(716) 646-4611

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1912938390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-649-0887",
            "fax_number": "716-646-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-649-0887",
            "fax_number": "716-646-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRA",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "223702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000526975004",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02300769",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026057803",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "3993967",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott John Seier, DDS
• Robert Semidey, M.D.
• Kimberly Sendlak
• Victoria Serafin
• Mary Catherine Serr
• Julia Setlock
• Kelsey Grace Seward, MS OTR/L
• Alicia M Seweryn, PT
• Mark M Shaw
• Jacqueline Marie Shellum

• Internal Medicine Physician in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; 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.