Individual provider Active NPI

Semere Tekie

  • Family Nurse Practitioner
  • Roxbury, MA
National Provider Identifier
1083070197
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN277574 Issued in MA
Practice address
76 Munroe St
Unit 2
Roxbury, MA 02119-1611
Phone
(617) 959-7911
NPI assigned
Jan 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN277574 MA Primary

Addresses

Primary practice location

76 Munroe St
Unit 2
Roxbury, MA 02119-1611

Mailing address

819 Worcester St
Ste 3
Springfield, MA 01151-1056
Phone (413) 543-6820

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160808001040 MA Practitioner - Nurse Practitioner 6406140862 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Acute Care Specialists PC CurrentSince Jul 1, 2017 Accepting new patients
Ipc Hospitalists of New England PC CurrentSince Jun 27, 2016 Accepting new patients
CS Pacs 3 Northeast, LLC CurrentSince Aug 23, 2024 Accepting new patients
Ipc Hospitalists of New England, P.C. Family Current Accepting new patients
Ma Pacs 2 PC CurrentSince Sep 19, 2020 Accepting new patients
Massachusetts Post Acute Medical Services 1 PC CurrentSince Sep 1, 2017 Accepting new patients
Ipc Hospitalists of New England, P.C. Family CurrentSince Jun 27, 2016 Accepting new patients

Locations

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

37 State Highway 6A
Sandwich, MA 02563
Phone (508) 888-8222

819 Worcester St
Ste 3
Springfield, MA 01151
Phone (413) 543-6820

50 Indian Neck Rd
Wareham, MA 02571
Phone (508) 295-3484

101 Plantation St
Worcester, MA 01604
Phone (501) 604-3025

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1083070197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST",
            "address_2": "STE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-543-6820",
            "fax_number": "413-543-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 MUNROE ST",
            "address_2": "UNIT 2",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191611",
            "telephone_number": "617-959-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEKIE",
        "first_name": "SEMERE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-05",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN277574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.