Individual provider Active NPI

Mariastella Serrano, MD

  • Pediatric Gastroenterology Physician
  • Washington, DC
National Provider Identifier
1922080126
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
MD045865 Issued in DC
Practice address
4200 Wisconsin Ave NW Ste 400
Washington, DC 20016-2100
Phone
(202) 243-3558
Fax
(877) 680-5504
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X MD045865 DC Primary

Addresses

Primary practice location

4200 Wisconsin Ave NW Ste 400
Washington, DC 20016-2100

Mailing address

4200 Wisconsin Ave NW Ste 400
Washington, DC 20016-2100
Phone (202) 243-3558

Other identifiers 3

IdentifierTypeStateIssuer
0435776MedicaidIA
1113905MedicaidLA
08172388MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20180312000091 DC Practitioner - Pediatric Medicine 6800828153 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Medical Group II LLCGroup PAC ID 0547413825, 3,726 clinicians

Practice addresses (Care Compare)

3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone (202) 444-2000

6410 Rockledge Dr
Bethesda, MD 20817-1844

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD045865DCMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
MGMC, LLC CurrentSince Feb 1, 2018 Accepting new patients
Medstar Medical Group II LLC CurrentSince Feb 1, 2018 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients
Medstar Georgetown Medical Center, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4200 Wisconsin Ave NW
Ste 200
Washington, DC 20016
Phone (267) 825-2184

4200 Wisconsin Ave NW
Ste 400
Washington, DC 20016
Phone (202) 243-3558

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

Organizations & group practices 8

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1922080126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 400",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162100",
            "telephone_number": "202-243-3558",
            "fax_number": "877-680-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 400",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162100",
            "telephone_number": "202-243-3558",
            "fax_number": "877-680-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "MARIASTELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "DC",
            "license": "MD045865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0435776",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1113905",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08172388",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.