SERRA HUBERTY MD - NPI 1063109098 - Student in an Organized Health Care Education/Training Program in Minneapolis, MN

Q: What is Serra Huberty's NPI number?

The NPI number for Serra Huberty is 1063109098. It was assigned to this individual provider in the NPPES registry on April 19, 2023.

Q: What is Serra Huberty's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Serra Huberty was last updated on June 23, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Serra Huberty Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SERRA HUBERTY MD (NPI 1063109098) is an individual student in an organized health care education/training program in Minneapolis, Minnesota and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063109098

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameSERRA HUBERTYCredential: MD

Location Address420 DELAWARE ST SE STE 195Minneapolis, MN 55455-2202

Mailing Address420 Delaware St Se Ste 195Minneapolis, MN 55455-2202 · (612) 625-6483

Phone(612) 625-6483

Sole ProprietorNo

Enumeration DateApril 19, 2023

Last NPPES UpdateJune 23, 20252 updates tracked since enumeration

NPPES CertifiedJune 23, 2025

✔ NPI 1063109098 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

420 DELAWARE ST SE STE 195, Minneapolis, MN 55455

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Serra Huberty Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHNNY SUZUKI

Student in an Organized Health Care Education/Training Program