Individual provider Active NPI

Hanna H Serdarevic, M.D.

  • Anesthesiology Physician
  • San Diego, CA
National Provider Identifier
1942438569
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A121603 Issued in CA
Practice address
3626 Ruffin Rd
San Diego, CA 92123-1810
Phone
(858) 565-9666
Fax
(858) 565-9441
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A121603 CA Primary

Addresses

Primary practice location

3626 Ruffin Rd
San Diego, CA 92123-1810

Mailing address

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (858) 565-9666

Other identifiers 1

IdentifierTypeStateIssuer
1942438569MedicaidCA

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
I20140911000676 CA Practitioner - Anesthesiology 6507097615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Rochester School of Medicine and Dentistry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Service Medical GroupGroup PAC ID 1153223219, 236 clinicians

Practice addresses (Care Compare)

3626 Ruffin Rd
San Diego, CA 92123-1810
Phone (619) 565-9666

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121603CAMDSocial Worker
A121603CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scripps Health Current Accepting new patients
Anesthesia Service Medical Group Anesthesiology CurrentSince Apr 6, 2015 Accepting new patients
Sutter Valley Hospitals Past Accepting new patients

Locations

3626 Ruffin Rd
San Diego, CA 92123
Phone (619) 565-9666

Interoperability endpoints

  • Direct secure messaging: hserdarevic34813@scrippshlth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428278400000",
    "number": "1942438569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 RUFFIN RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231810",
            "telephone_number": "858-565-9666",
            "fax_number": "858-565-9441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERDAREVIC",
        "first_name": "HANNA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2015-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A121603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942438569",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.