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MIGUEL ANGEL SERRANO-ILLAN
NPI 1649910480
Psychiatry & Neurology - Psychiatry in Los Angeles, CA

Active since March 30, 2022PECOS Enrolled
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073(310) 478-3711 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Miguel Angel Serrano-illan NPPES

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

MIGUEL ANGEL SERRANO-ILLAN (NPI 1649910480) is an individual psychiatry provider in Los Angeles, California, licensed in California (A188869) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS, maintains a secondary practice location in Los Angeles, and is a graduate of Loma Linda University School Of Medicine (2022).

NPPES Registry Identity

NPI1649910480
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameMIGUEL ANGEL SERRANO-ILLAN
Location Address11301 WILSHIRE BLVDLos Angeles, CA 90073-1003
Mailing Address757 Westwood PlzLos Angeles, CA 90095-7419 · (310) 206-6721
Phone(310) 478-3711
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 2022
Enumeration DateMarch 30, 2022
Last NPPES UpdateOctober 31, 2024
NPPES CertifiedOctober 31, 2024
✔ NPI 1649910480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in CA · A188869
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
11301 WILSHIRE BLVD, Los Angeles, CA 90073
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Other Names 1

Other Name (5)Miguel Angel Serrano

Secondary Practice Location 1

Location 1150 Medical Plaza DrivewayLos Angeles, CA 90095-0001 · Phone (319) 825-9111

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miguel Angel Serrano-illan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133687924
PECOS Enrollment IDI20260821003106
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 Reassignment

Medicare enrollment records show Miguel Serrano-illan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ehab Yacoub MD Inc.
16 mi
Child & Adolescent Psychiatry
1225 W 190TH ST STE 280
Gardena, CA 90248
  • Reassigned Medicare billing, California enrollment
  • 375 clinicians in this Medicare group
NPI 1417373713 (310) 515-8113

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90073 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$187.60 typical visit price
range $62.96 – $187.60
Typical copayment $46.90 (range $15.74 – $46.90)
Most-billed visit code 99205
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

JOANNA ZUHAIL CENTENO I
Licensed Vocational Nurse
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 478-3711
MS. APRIL S. BULLOCK MSW,ACSW
Social Worker
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 268-3000
NICOLE CHAN LISW
Social Worker
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 487-6026
DANIEL SMEE SOCIAL WORK
Social Worker (Clinical)
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 478-3711
AMANDA SALVESTRINI MS, RD
Dietitian, Registered
11301 WILSHIRE BLVD, BUILDING 213. 3RD FLOOR. ROOM 317.
LOS ANGELES, CA 90073
Los Angeles County (310) 478-3711
RACHEL DAJANI MD
Internal Medicine
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 478-3711
HARRISON BODRIE LCSW
Social Worker (Clinical)
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 987-8310
MR. ROBERTO CARMONA-VERGARA ASW
Student in an Organized Health Care Education/Training Program
11301 WILSHIRE BLVD
LOS ANGELES, CA 90073
Los Angeles County (310) 478-3711

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 Miguel Serrano-illan's NPI number?

The NPI number for Miguel Serrano-illan is 1649910480. It was assigned to this individual provider in the NPPES registry on March 30, 2022. The provider is also known as Miguel Angel Serrano.

Where is Miguel Serrano-illan located?

Miguel Serrano-illan practices at 11301 Wilshire Blvd, Los Angeles, CA 90073. The listed phone number is (310) 478-3711.

What is Miguel Serrano-illan's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Miguel Serrano-illan enrolled in Medicare?

Yes. Miguel Serrano-illan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Miguel Serrano-illan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Miguel Serrano-illan reassigns Medicare benefits to Ehab Yacoub MD Inc. (Gardena, CA). The 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 Miguel Serrano-illan'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 Miguel Serrano-illan was last updated on October 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months 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.