Individual provider Active NPI

Tor Martin Ljung, MD

  • Plastic and Reconstructive Surgery Physician
  • Wilmington, NC
National Provider Identifier
1043356868
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
200000088 Issued in NC
Practice address
6752 Parker Farm Dr # 200
Wilmington, NC 28405-3175
Phone
(910) 341-3300
Fax
(910) 341-3321
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 200000088 NC Primary

Addresses

Primary practice location

6752 Parker Farm Dr # 200
Wilmington, NC 28405-3175

Mailing address

1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone (910) 341-3300

Other identifiers 1

IdentifierTypeStateIssuer
89126PGMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20091008000637 NC Practitioner - Plastic and Reconstructive Surgery 0547355208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

1222 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

6727 Parker Farm Dr
Wilmington, NC 28405-3176
Phone (910) 341-1540

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy15
Melanoma (skin cancer) excision21
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22734ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince May 1, 2011 Accepting new patients
Wha Medical Clinic PLLC Current Accepting new patients
Wilmington Health PLLC Current Accepting new patients
Wilmington Health PLLC CurrentSince May 1, 2011 Accepting new patients

Locations

1300 Bridge Barrier Rd
Ste 2
Carolina Beach, NC 28428
Phone (910) 458-4101

1333 S Dickinson Dr
Leland, NC 28451
Phone (910) 332-0241

2511 Delaney Ave
Wilmington, NC 28403
Phone (910) 667-9328

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

6752 Parker Farm Dr
#200
Wilmington, NC 28405

6727 Parker Farm Dr
Wilmington, NC 28405
Phone (910) 343-1031

2421 Silver Stream Ln
Wilmington, NC 28401
Phone (910) 763-2072

8108 Market St
#B
Wilmington, NC 28411
Phone (910) 686-2099

Interoperability endpoints

  • Direct secure messaging: tor.ljung.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 4

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1043356868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6752 PARKER FARM DR # 200",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053175",
            "telephone_number": "910-341-3300",
            "fax_number": "910-341-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LJUNG",
        "first_name": "TOR",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "200000088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89126PG",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.