Tadele Wunete Alemu, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

C0003480 Issued in MD

Practice address

300 Armory Place
Suite 3M
Baltimore, MD 21201

Phone

(410) 225-8615

Fax

(410) 462-5095

NPI assigned

May 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Mdics at Bon Secours LLC

  • Hospitalist Physician
  • Baltimore, MD
  • NPI 1679868848
  NPD (past)

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578700800000",
    "number": "1083828552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 UPLAND DRIVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22310",
            "telephone_number": "703-313-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ARMORY PLACE",
            "address_2": "SUITE 3M",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-225-8615",
            "fax_number": "410-462-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEMU",
        "first_name": "TADELE",
        "middle_name": "WUNETE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2020-01-11",
        "certification_date": "2020-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0003480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alegria Wellness Services
• Alberto Alejandro, DMD
• Joel Manuel P Alejandro, MD
• Julie Catalina Alejo, MD
• Danayt Alem
• Holly Alesbury, PA-C
• Larry E Alessi, M.D.
• Melanie Ann Alevetsovitis
• Christen A. Alevizatos, M.D.
• Argyro Alevrogiannis, P.T.

• All providers in Baltimore, MD
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.