Individual provider Active NPI

Serena A Tu, MD

  • Pediatrics Physician
  • Glendale, CA
National Provider Identifier
1922088459
Registry record updated May 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A68366 Issued in CA
Practice address
1500 S Central Ave
Suite 100
Glendale, CA 91204-2530
Phone
(818) 637-7980
Fax
(818) 637-7985
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A68366 CA Primary

Addresses

Primary practice location

1500 S Central Ave
Suite 100
Glendale, CA 91204-2530

Mailing address

1500 S Central Ave
#100
Glendale, CA 91204-2530
Phone (818) 637-7980

Other identifiers 1

IdentifierTypeStateIssuer
A683660MedicaidCA

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
I20120814000612 CA Practitioner - Pediatric Medicine 8022264605 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68366CAMDPharmacist
A68366CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Physicians Network CurrentSince Jul 4, 2012 Accepting new patients
Adventist Health Physicians Network Current Accepting new patients
Adventist Health Physicians Network CurrentSince Jul 4, 2012 Accepting new patients

Locations

1975 Verdugo Blvd
La Canada Flintridge, CA 91011
Phone (818) 249-9454

1975 Verdugo Blvd
Ste B
La Canada Flintridge, CA 91011
Phone (818) 637-7980

234 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-0681

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273536000000",
    "number": "1922088459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE",
            "address_2": "#100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042530",
            "telephone_number": "818-637-7980",
            "fax_number": "818-637-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S CENTRAL AVE",
            "address_2": "SUITE 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042530",
            "telephone_number": "818-637-7980",
            "fax_number": "818-637-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TU",
        "first_name": "SERENA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2010-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A68366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A683660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.