Individual provider Active NPI

Eric David Duberman, M.D.

  • Surgery Physician
  • Cary, NC
National Provider Identifier
1093796203
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200101036 Issued in NC
Practice address
155 Parkway Office CT
Cary, NC 27518-7426
Phone
(919) 859-4747
Fax
(919) 859-4757
NPI assigned
Nov 7, 2005
Last updated
Apr 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 200101036 NC Primary
Surgery Physician 208600000X 73992 NC
Colon & Rectal Surgery Physician 208C00000X 73992 NC

Addresses

Primary practice location

155 Parkway Office CT
Cary, NC 27518-7426

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (877) 498-4490

Other identifiers 2

IdentifierTypeStateIssuer
891295YMedicaidNC
1093796203MedicaidNC

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
I20040603001322 NC Practitioner - Colorectal Surgery (Proctology) 9830170034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
Columbia University College of Physicians and Surgeons, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-7270

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)31
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
73992NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Jan 1, 2022 Accepting new patients
Wakemed Specialists Group LLC CurrentSince Jan 1, 2022 Accepting new patients
Wakemed Specialists Group, LLC Surgery Current Accepting new patients

Locations

155 Parkway Office Ct
Cary, NC 27518
Phone (919) 859-4747

155 Parkway Office Ct
Ste 101
Cary, NC 27518
Phone (919) 859-4747

160 Macgregor Pines Dr
Ste 310
Cary, NC 27511
Phone (919) 234-4470

300 Ashville Ave
Ste 200
Cary, NC 27518
Phone (919) 650-3325

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1093796203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 PARKWAY OFFICE CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275187426",
            "telephone_number": "919-859-4747",
            "fax_number": "919-859-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBERMAN",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "200101036",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "73992",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "NC",
            "license": "73992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891295Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093796203",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.