Serene Selli, DO
Individual provider Active NPI Family Medicine Physician · Navasota, TX
NPI 1992331888 · NPPES record last updated Jun 27, 2023
Key facts
- NPI
- 1992331888
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- T4844 (TX)
- Practice address
- 1905 Dove Crossing LN
Navasota, TX 77868-5272 - Phone
- (368) 250-7559
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of North Texas HSC, College of Osteopathic Med, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Texas Aandm University System Health Science Center
Privia Medical Group Gulf Coast PLLC
Practice addresses (Care Compare)
2900 E 29TH St
Suite 200
Bryan, TX 77802-2623
Phone (979) 776-8440
7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500
Hospital & facility affiliations
- Grimes St Joseph Health Center
- CHI St Joseph Health Regional Hospital
- Baylor Scott & White Medical Center- College Stati
- Grimes St Joseph Health Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220420002592 | TX | Practitioner - Family Practice | 9436571932 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T4844 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas a&M University System Health Science Center | Family Medicine | Current |
Accepting new patients |
| Privia Medical Group Gulf Coast PLLC | Current |
Accepting new patients | |
| Texas a&M University System Health Science Center | Current |
Accepting new patients | |
| Privia Medical Group Gulf Coast, PLLC | Current |
Accepting new patients |
Locations
2900 E 29th St
Ste 100
Bryan, TX 77802
Phone (979) 436-0485
1301 Memorial Dr
Ste 100
Bryan, TX 77802
Phone (979) 862-4465
2900 E 29th St
Ste 200
Bryan, TX 77802
Phone (979) 436-0483
2900 E 29th St
Bryan, TX 77802
Phone (979) 436-0700
646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001
7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027
1200 Binz St
Ste 1490
Houston, TX 77004
Phone (713) 512-7027
1905 Dove Crossing Ln
Ste A
Navasota, TX 77868
Phone (936) 825-0755
10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500
17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820
Interoperability endpoints
- serene.selli.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Medicine Physician | 207Q00000X | T4844 | TX | Yes |
Addresses
Primary practice location
1905 Dove Crossing LN
Navasota, TX 77868-5272
Mailing address
2900 E 29TH St
Ste 100
Bryan, TX 77802-2623
Phone (979) 436-0483
Other providers in Navasota, TX
- Patricia Sammarelli
- Rama Sarathy II
- Doris Sauls
- Scamardo MHT LLC
- Luke P Scamardo II
- Pollachi P Selvakumarraj
- Nisarg Shah
- Smith & Williams Community Healthcare LLC
- Linda Carol Snow
- St Joseph Regional Health Center
All providers in Navasota, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.