Individual provider Active NPI

Admir Seferovic, MD

  • Family Medicine Physician
  • Tyler, TX
National Provider Identifier
1477763795
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q2492 Issued in TX
Practice address
11937 US Highway 271
Tyler, TX 75708-3154
Phone
(903) 877-7200
Fax
(903) 877-5080
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q2492 TX
Family Medicine Physician 207Q00000X Q2492 TX Primary

Addresses

Primary practice location

11937 US Highway 271
Tyler, TX 75708-3154

Mailing address

PO Box 731912
Dallas, TX 75373-1912
Phone (903) 877-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ADMIR.SEFEROVIC@hca4.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150114001966 TX Practitioner - Emergency Medicine 3173702933 Reassigns benefits to 1 organization
I20241010000048 OR Practitioner - Family Practice 3173702933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10330 SE 32ND Ave
Suite 205
Milwaukie, OR 97222-6594
Phone (503) 513-8950

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q2492TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Oct 21, 2024 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince Dec 1, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Oct 21, 2024 Accepting new patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince Dec 1, 2014 Accepting new patients

Locations

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

2701 US Highway 271 N
Pittsburg, TX 75686
Phone (903) 946-5000

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Interoperability endpoints

  • Direct secure messaging: aseferovic3502552@oc.providencedirect.org

Organizations & group practices 5

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1477763795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731912",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753731912",
            "telephone_number": "903-877-7200",
            "fax_number": "903-877-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11937 US HIGHWAY 271",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757083154",
            "telephone_number": "903-877-7200",
            "fax_number": "903-877-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEFEROVIC",
        "first_name": "ADMIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q2492",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q2492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ADMIR.SEFEROVIC@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "11937 US Highway 271",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757083154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.