Individual provider Active NPI

Jamie Lynn Benedek Serrano, D.O.

  • Surgery Physician
  • Kinston, NC
National Provider Identifier
1992156780
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101022407 Issued in MI
Practice address
204 Airport Rd
Kinston, NC 28504-8814
Phone
(252) 775-5999
Fax
(252) 208-1647
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 5101022407 MI Primary

Addresses

Primary practice location

204 Airport Rd
Kinston, NC 28504-8814

Mailing address

2000 Perimeter Park Dr Ste 200
Morrisville, NC 27560-8442

Other practice location 1

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jserrano775600@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20211105000543 NC Practitioner - General Surgery 1557653664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

100 Airport Rd
Kinston, NC 28501-1604

204 Airport Rd
Kinston, NC 28504-8814
Phone (252) 775-5999

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514-2601
Phone (919) 942-5123

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue16
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101022407MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
Unc Physicians Network LLC CurrentSince Oct 27, 2021 Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

204 Airport Rd
Kinston, NC 28504
Phone (252) 527-9928

204 Airport Rd
Ste A2
Kinston, NC 28504
Phone (252) 775-5940

100 Airport Rd
Fl 5
Kinston, NC 28501
Phone (252) 775-5920

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

Interoperability endpoints

  • Direct secure messaging: jserrano775600@direct.unc.nchie.net

Organizations & group practices 2

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1992156780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PERIMETER PARK DR STE 200",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "275608442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 AIRPORT RD",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285048814",
            "telephone_number": "252-775-5999",
            "fax_number": "252-208-1647"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5900 Byron Center Ave SW",
            "address_purpose": "LOCATION",
            "city": "Wyoming",
            "state": "MI",
            "postal_code": "495199606",
            "country_code": "US",
            "telephone_number": "616-252-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "JAMIE",
        "middle_name": "LYNN BENEDEK",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101022407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jserrano775600@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "204 Airport Rd",
            "city": "Kinston",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285048814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.