NPIMap

Individual provider Active NPI

Lelise Endale

  • Medical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1316367881
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C0004978 Issued in MD
Practice address
300 E Madison St
Baltimore, MD 21202-4260
Phone
(410) 545-8102
NPI assigned
Apr 23, 2014
Last updated
Apr 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0004978 MD Primary
Medical Physician Assistant 363AM0700X PA030906 DC

Addresses

Primary practice location

300 E Madison St
Baltimore, MD 21202-4260

Mailing address

425 Holiday Dr
Pittsburgh, PA 15220-2714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180906002288 DC Practitioner - Physician Assistant 3476803727 Reassigns benefits to 5 organizations
I20190711000802 MD Practitioner - Physician Assistant 3476803727 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Hospital Center IncGroup PAC ID 6204739352, 90 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 701-4434

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA030906DCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Center, Inc. CurrentSince Oct 9, 2023 Accepting new patients
State of Maryland Central Payroll Bureau CurrentSince Dec 1, 2023 Accepting new patients
Northwest Hospital Center, Inc CurrentSince Oct 9, 2023 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Mar 29, 2019 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince Mar 29, 2019 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Aug 1, 2018 Accepting new patients
Genesis Eldercare Physician Services LLC CurrentSince May 1, 2019 Accepting new patients
Emergency Medicine Associates PA CurrentSince Aug 1, 2018 Accepting new patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Dec 1, 2023 Accepting new patients

Locations

300 W Preston St
Ste 402
Baltimore, MD 21201
Phone (410) 767-2940

3330 Wilkens Ave
Baltimore, MD 21229
Phone (410) 525-1544

347 Ballenger Center Dr
Frederick, MD 21703
Phone (301) 633-5181

8118 Good Luck Rd
Lanham Seabrook, MD 20706
Phone (301) 552-8608

1801 Wentworth Rd
Parkville, MD 21234
Phone (410) 661-5717

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

310 Genesis Way
Ste 600
Severna Park, MD 21146
Phone (410) 544-4220

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

6655 Sykesville Rd
Sykesville, MD 21784
Phone (410) 970-7000

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

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

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1316367881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HOLIDAY DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152202714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MADISON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024260",
            "telephone_number": "410-545-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDALE",
        "first_name": "LELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0004978",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "DC",
            "license": "PA030906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.