Individual provider Active NPI

Edwin N. Tenali, P.A.

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1023055498
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C03271 Issued in MD
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-2882
Fax
(410) 328-2977
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C03271 MD Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64442
Baltimore, MD 21264-4442
Phone (410) 328-2882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060710000114 MD Practitioner - Physician Assistant 3375556566 Reassigns benefits to 5 organizations
I20140903000835 DC Practitioner - Physician Assistant 3375556566 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Associates P.a., P.C.Group PAC ID 8022914522, 706 clinicians
Mep Observation Services LLCGroup PAC ID 2365611845, 42 clinicians

Practice addresses (Care Compare)

200 Memorial Ave
Westminster, MD 21157-5726
Phone (410) 871-6700

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200

Hospital & facility affiliations

  • Carroll Hospital Center Hospital, Westminster, MD, CCN 210033
  • Northwest Hospital Center Hospital, Randallstown, MD, CCN 210040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C03271MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 23, 2019 Accepting new patients
Mep Observation Services LLC CurrentSince May 1, 2025 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Aug 1, 2017 Accepting new patients
Emergency Medicine Associates, PA CurrentSince Apr 23, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Apr 23, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

3227 Bel Pre Rd
Silver Spring, MD 20906
Phone (301) 871-2000

7600 Carroll Ave
Takoma Park, MD 20912
Phone (301) 791-7600

200 Memorial Ave
Westminster, MD 21157
Phone (410) 848-3000

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

100 Fairview Dr
Franklin, VA 23851
Phone (757) 516-1153

Organizations & group practices 10

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1023055498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64442",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644442",
            "telephone_number": "410-328-2882",
            "fax_number": "410-328-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-2882",
            "fax_number": "410-328-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENALI",
        "first_name": "EDWIN",
        "middle_name": "N.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C03271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.