Individual provider Active NPI

Wagahta Semere, M.D.

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1598080517
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
51917 Issued in CT
Practice address
20 York St
New Haven, CT 06510-3220
Phone
(203) 688-2470
Fax
(203) 688-4516
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 51917 CT Primary

Addresses

Primary practice location

20 York St
New Haven, CT 06510-3220

Mailing address

333 Cedar St
P.O. Box 208033
New Haven, CT 06510-3206
Phone (203) 688-2470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20170817002090 CA Practitioner - Internal Medicine 3375785900 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51917CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
City & County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
University of California SFGH Medical Group Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
City and County of San Francisco CurrentSince Nov 10, 2019 Accepting new patients
City & County of San Francisco Current Accepting new patients
University of California SFGH Medical Group Current Accepting new patients
University of California SFGH Medical Group CurrentSince Sep 1, 2017 Accepting new patients

Locations

1001 Potrero Ave
San Francisco, CA 94110
Phone (415) 206-2305

1001 Potrero Ave
Rm 5H22
San Francisco, CA 94110
Phone (628) 206-4774

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.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1598080517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CEDAR ST",
            "address_2": "P.O. BOX 208033",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103206",
            "telephone_number": "203-688-2470",
            "fax_number": "203-688-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-2470",
            "fax_number": "203-688-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMERE",
        "first_name": "WAGAHTA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "51917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.