Individual provider Active NPI

Tatyana Sergeyeva, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Glen Burnie, MD
National Provider Identifier
1164599205
Registry record updated Oct 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
D0068091 Issued in MD
Practice address
300 Hospital Dr
Suite 119
Glen Burnie, MD 21061-6902
Phone
(410) 787-4940
Fax
(410) 787-4941
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X A94215 CA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X D0068091 MD Primary

Addresses

Primary practice location

300 Hospital Dr
Suite 119
Glen Burnie, MD 21061-6902

Mailing address

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 787-4594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081105000772 MD Practitioner - EndocrinologyPractitioner - Internal Medicine 3779642780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

219 S Washington St
Easton, MD 21601-2913
Phone 41082210005845

Hospital & facility affiliations

  • University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A94215CAMDEndocrinology, Diabetes & Metabolism Physician
D0068091MDMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Baltimore Washington Medical Center Inc. Endocrinology, Diabetes & Metabolism Past Accepting new patients
Arundel Physicians Associates, LLC Past Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

305 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 553-8100

300 Hospital Dr
Ste 119
Glen Burnie, MD 21061
Phone (410) 553-8240

255 Hospital Dr
Ste 207
Glen Burnie, MD 21061
Phone (410) 443-8170

Interoperability endpoints

  • Direct secure messaging: tsergeyeva23912@direct.umm.edu

Organizations & group practices 6

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 1

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413417600000",
    "number": "1164599205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615803",
            "telephone_number": "410-787-4594",
            "fax_number": "410-787-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "address_2": "SUITE 119",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210616902",
            "telephone_number": "410-787-4940",
            "fax_number": "410-787-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGEYEVA",
        "first_name": "TATYANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "A94215",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MD",
            "license": "D0068091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

Verify at the official NPI Registry.