Individual provider Active NPI

Rod D Serry, M.D.

  • Interventional Cardiology Physician
  • Escondido, CA
National Provider Identifier
1912945130
Registry record updated Jan 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A76061 Issued in CA
Practice address
1955 W Citracado Pkwy
Suite 300
Escondido, CA 92029-4113
Phone
(760) 743-0546
Fax
(760) 743-8837
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X A76061 CA Primary
Cardiovascular Disease Physician 207RC0000X 036102630 IL

Addresses

Primary practice location

1955 W Citracado Pkwy
Suite 300
Escondido, CA 92029-4113

Mailing address

PO Box 28199
San Diego, CA 92198-0199
Phone (858) 673-2574

Other identifiers 1

IdentifierTypeStateIssuer
1912945130MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041203000565 CA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7315903168 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Rush Medical College of Rush University, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arch Health Partners IncGroup PAC ID 9931239027, 141 clinicians

Practice addresses (Care Compare)

15611 Pomerado Rd
Poway, CA 92064-2437
Phone (858) 675-3100

1955 Citracado Pkwy
Suite 302
Escondido, CA 92029-4113
Phone (760) 233-1896

2125 Citracado Pkwy
Escondido, CA 92029-4159

Hospital & facility affiliations

  • Palomar Health Downtown Campus Hospital, Escondido, CA, CCN 050115
  • Palomar Medical Center Poway Hospital, Poway, CA, CCN 050636

Merit-based Incentive Payment System (MIPS)

Final score
23.02 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
76.74

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting32
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
76061CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Arch Health Partners, Inc Cardiovascular Disease CurrentSince Oct 1, 2012 Accepting new patients
Madi Med LLC Cardiovascular Disease CurrentSince Jan 1, 2025 Accepting new patients
Palomar Health Past Accepting new patients

Locations

1980 Felicita Rd
Escondido, CA 92025
Phone (750) 741-6109

1955 Citracado Pkwy
Ste 300
Escondido, CA 92029
Phone (760) 294-1281

2130 Citracado Pkwy
Ste 220
Escondido, CA 92029
Phone (619) 823-3146

488 E Valley Pkwy
Ste 201
Escondido, CA 92025
Phone (760) 489-1458

15611 Pomerado Rd
Ste 580
Poway, CA 92064
Phone (858) 592-2696

15611 Pomerado Rd
Ste 400
Poway, CA 92064
Phone (858) 613-8900

15720 Bernardo Center Dr
San Diego, CA 92127
Phone (858) 500-2693

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rserry42719@scrippshlth.medalliesdirect.net
  • Direct secure messaging: rod.serry.p1@direct.arch.nextgenshare.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421366400000",
    "number": "1912945130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28199",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921980199",
            "telephone_number": "858-673-2574",
            "fax_number": "858-618-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 W CITRACADO PKWY",
            "address_2": "SUITE 300",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920294113",
            "telephone_number": "760-743-0546",
            "fax_number": "760-743-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRY",
        "first_name": "ROD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A76061",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036102630",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912945130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.