Individual provider Active NPI

Devieka Serafin

  • Specialist
  • Bayside, NY
National Provider Identifier
1932526183
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
786756131 Issued in NY
Practice address
21350 36TH Ave
Bayside, NY 11361-1547
Phone
(917) 440-8535
NPI assigned
Mar 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 786756131 NY Primary

Addresses

Primary practice location

21350 36TH Ave
Bayside, NY 11361-1547

Mailing address

21350 36TH Ave
Bayside, NY 11361-1547
Phone (917) 440-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
786756131NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1932526183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21350 36TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611547",
            "telephone_number": "917-440-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21350 36TH AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113611547",
            "telephone_number": "917-440-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFIN",
        "first_name": "DEVIEKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "786756131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayside, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.