Organization Active NPI

Motsen LLC

  • Occupational Medicine Clinic/Center
  • Bethesda, MD
National Provider Identifier
1043636608
Registry record updated Nov 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
MOTSEN LLC
Practice address
4641 Montgomery Ave Ste 10
Bethesda, MD 20814-3590
Phone
(301) 657-3033
Fax
(240) 408-7887
NPI assigned
Mar 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2020

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

Authorized official

Name
Thomas Musembi
Title
General Manager
Phone
(301) 657-3033

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X
Occupational Medicine Clinic/Center 261QX0100X Primary
Clinical Medical Laboratory 291U00000X 1538477971 MD
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

4641 Montgomery Ave Ste 10
Bethesda, MD 20814-3590

Mailing address

4641 Montgomery Ave
Suite 10 Lower Level
Bethesda, MD 20814-3488
Phone (301) 657-3033

Other identifiers 10

IdentifierTypeStateIssuer
1326574799OtherNPI-DR TEAGUE
1932455300MedicaidMD
1518028984MedicaidMD
1306092135OtherNPI- DR. MCCALL
1306092135MedicaidMD
1518028984OtherNPI DR. KARM
1588190813MedicaidMD
1932455300OtherNPI DR. BEY
1326574799MedicaidMD
1588190813OtherNPI-DR. AJOSE

Other names 1

  • Buckley's Renewal Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2058137Buckley'S Renewal Center4641 Montgomery Ave Suite 10, Bethesda, MD 20814Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory

Locations

4641 Montgomery Ave
Ste 10
Bethesda, MD 20814
Phone (301) 657-3033

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1043636608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4641 MONTGOMERY AVE",
            "address_2": "SUITE 10 LOWER LEVEL",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143488",
            "telephone_number": "301-657-3033",
            "fax_number": "301-657-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4641 MONTGOMERY AVE STE 10",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143590",
            "telephone_number": "301-657-3033",
            "fax_number": "240-408-7887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOTSEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "MUSEMBI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "301-657-3033"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "1538477971",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-DR TEAGUE",
            "identifier": "1326574799",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932455300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518028984",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- DR. MCCALL",
            "identifier": "1306092135",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306092135",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DR. KARM",
            "identifier": "1518028984",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588190813",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI DR. BEY",
            "identifier": "1932455300",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326574799",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-DR. AJOSE",
            "identifier": "1588190813",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckley's Renewal Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Buckley's Renewal Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.