NPIMap

Individual provider Active NPI

Semere Teclay, PA-C

  • Surgical Physician Assistant
  • Baltimore, MD
National Provider Identifier
1528231792
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
C03581 Issued in MD
Practice address
2401 W Belvedere Ave
Baltimore, MD 21215-5216
Phone
(410) 601-8961
NPI assigned
Apr 9, 2008
Last updated
Aug 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C3581 MD
Surgical Physician Assistant 363AS0400X C03581 MD Primary

Addresses

Primary practice location

2401 W Belvedere Ave
Baltimore, MD 21215-5216

Mailing address

2401 W Belvedere Ave
Orthopaedic
Baltimore, MD 21215-5216
Phone (410) 601-8691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20110203000130 MD Practitioner - Physician Assistant 6709066087 Reassigns benefits to 3 organizations
I20171228001542 DC Practitioner - Physician Assistant 6709066087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Sinai Hospital of Baltimore, IncGroup PAC ID 0941112346, 373 clinicians

Practice addresses (Care Compare)

2401 E Belvedere Ave
Baltimore, MD 21215-5216

2411 W Belvedere Ave
Baltimore, MD 21215-5217

2411 W Belvedere Ave 5TH Floor
Sinai Ophthalmology Associates
Baltimore, MD 21215-5217
Phone (410) 601-5700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C3581MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc CurrentSince Nov 11, 2010 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 30, 2021 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Oct 28, 2017 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Nov 11, 2010 Accepting new patients
MNR Industries, LLC CurrentSince Sep 28, 2016 Accepting new patients
MNR Industries, LLC CurrentSince Sep 28, 2016 Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jul 30, 2021 Accepting new patients
Yardmore Emergency Physicians LLC Past Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

2411 W Belvedere Ave
Baltimore, MD 21215
Phone (410) 601-8314

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 13

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 13

Hospital & facility affiliations 2

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1528231792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "address_2": "ORTHOPAEDIC",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 W BELVEDERE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155216",
            "telephone_number": "410-601-8961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TECLAY",
        "first_name": "SEMERE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C3581",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C03581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.