NPIMap

Wakemed Specialists Group LLC

Organization Active NPI Rheumatology Physician · Raleigh, NC

NPI 1073178398 · NPPES record last updated Aug 21, 2019

Key facts

NPI
1073178398
Entity type
Organization (NPI type 2)
Primary specialty
Rheumatology Physician 207RR0500X
Legal business name
WAKEMED SPECIALISTS GROUP LLC
Practice address
10010 Falls of Neuse Rd
Raleigh, NC 27614-8494
Phone
(919) 235-6454
Fax
(919) 350-9878
NPI assigned
May 2, 2019
Organization subpart
No

Authorized official

Name
Maria Jayoussi
Title
Executive Director of Finance
Phone
(919) 350-6089

Other NPIs on the same Medicare enrollment 47

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 47

Practitioners 29

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

View all 29

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190731000815 NC Part B Supplier - Clinic/Group Practice 2466788377 Receives reassigned benefits from 1,327 practitioners
47 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207RR0500X Yes

Addresses

Primary practice location

10010 Falls of Neuse Rd
Raleigh, NC 27614-8494

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0552

Other identifiers

IdentifierTypeStateIssuer
1073178398MedicaidNC

Other names

  • WakeMed Rheumatology Other name

Other providers in Raleigh, NC

All providers in Raleigh, NC · Rheumatology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.