Personalized Hematology-Oncology of Wake Forest PLLC

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

200400833 Issued in NC

Legal business name

PERSONALIZED HEMATOLOGY-ONCOLOGY OF WAKE FOREST PLLC

Practice address

11635 North Park Drive
Wake Forest, NC 27587-6298

Phone

(919) 556-2907

Fax

(919) 435-1060

NPI assigned

Apr 27, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Luminita Castillos, PHD, MBA

Title

Practice Manager

Phone

(919) 556-2907

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Francisco A Castillos, MD

  • Hematology & Oncology Physician
  • Wake Forest, NC
  • NPI 1619978285

  Internal Medicine

  Medicare reassignment NPD
• Em Toe

  • Nurse Practitioner
  • Chapel Hill, NC
  • NPI 1609648997
  Medicare reassignment NPD
• Paul Vansweden, MD

  • Internal Medicine Physician
  • Rockingham, NC
  • NPI 1932428885
  Medicare reassignment NPD

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341446400000",
    "number": "1053679944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11635 NORTH PARK DRIVE",
            "address_2": "SUITE 250",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876298",
            "telephone_number": "919-825-4637",
            "fax_number": "919-435-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11635 NORTH PARK DRIVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876298",
            "telephone_number": "919-556-2907",
            "fax_number": "919-435-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALIZED HEMATOLOGY-ONCOLOGY OF WAKE FOREST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-07-05",
        "status": "A",
        "authorized_official_last_name": "CASTILLOS",
        "authorized_official_first_name": "LUMINITA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "919-556-2907",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD, MBA"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200400833",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "200400833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89137UC",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "137UC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Perkins Partial Hospital Program, PLLC
• Pamela S. Perkins, PSY.D.
• Jeffrey B Perrin, M.D.
• Perry Medical Resources LLC
• Beatrice W Perry, MA CCC-SLP
• Heather Louise Petersen, LCSW
• Julie Ann Peterson, M.A.,LPC
• Martin Tsvetanov Petkov
• Jeremy Phan, MS
• Shawn P Phelan, D.O.

• Hematology & Oncology Physician in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Hematology & Oncology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.