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MKRTICH SEROBYAN DO
NPI 1417692823
Student in an Organized Health Care Education/Training Program in Wyoming, MI

Active since April 29, 2022PECOS EnrolledAccepts Medicare Assignment
5900 BYRON CENTER AVE SW, WYOMING, MI 49519(616) 252-7200(616) 252-4953 Get Directions Write a Review

NPPES record last updated: April 22, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 22, 2024, Apr 29, 2022 (2 updates tracked since 2022).

About Mkrtich Serobyan Do NPPES

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

MKRTICH SEROBYAN DO (NPI 1417692823) is an individual student in an organized health care education/training program in Wyoming, Michigan and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1417692823
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMKRTICH SEROBYANCredential: DO
Location Address5900 BYRON CENTER AVE SWWyoming, MI 49519-9606
Mailing Address5900 Byron Center Ave SwWyoming, MI 49519-9606 · (616) 252-7200 · Fax (616) 252-4953
Phone(616) 252-7200
Fax(616) 252-4953
Sole ProprietorNo
Medical School CMSOtherGraduated 2022
Enumeration DateApril 29, 2022
Last NPPES UpdateApril 22, 20242 updates tracked since enumeration
NPPES CertifiedApril 22, 2024
✔ NPI 1417692823 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 5101027928 (MI)
5900 BYRON CENTER AVE SW, Wyoming, MI 49519
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mkrtich Serobyan Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264812106
PECOS Enrollment IDI20251008003041
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mkrtich Serobyan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Signify Health Medical Associates, PLLC
914 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Michigan enrollment
  • 666 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800
Southern California Permanente Medical Group
1,828 mi
Health Maintenance Organization
43112 N 15TH ST
Lancaster, CA 93534
  • Reassigned Medicare billing, California enrollment
  • 13,921 clinicians in this Medicare group
NPI 1982863783 (661) 726-2279

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

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

MATTHEW AARON ERCK DO
Internal Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
AMANDA BRONSON DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7078
GANESH KUMAR DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. SARAH PRATT DO
Student in an Organized Health Care Education/Training Program
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
CASSANDRA PAIGE FRITCH NP
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
DR. TRISTAN J WORTHINGTON DO
Family Medicine
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200
MRS. KELLY ANN MURPHY DNP, FNP-C
Nurse Practitioner (Family)
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-3900
REBECCA S ZERIAL PA-C
Physician Assistant
5900 BYRON CENTER AVE SW
WYOMING, MI 49519
Kent County (616) 252-7200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mkrtich Serobyan's NPI number?

The NPI number for Mkrtich Serobyan is 1417692823. It was assigned to this individual provider in the NPPES registry on April 29, 2022.

Where is Mkrtich Serobyan located?

Mkrtich Serobyan practices at 5900 Byron Center Ave SW, Wyoming, MI 49519. The listed phone number is (616) 252-7200.

What is Mkrtich Serobyan's specialty?

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

Is Mkrtich Serobyan enrolled in Medicare?

Yes. Mkrtich Serobyan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Mkrtich Serobyan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mkrtich Serobyan reassigns Medicare benefits to 2 organizations: Signify Health Medical Associates, PLLC (Dallas, TX) and Southern California Permanente Medical Group (Lancaster, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mkrtich Serobyan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mkrtich Serobyan was last updated on April 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.