NPIMap

Individual provider Active NPI

Kelly Ann Brozzetti-Cronin, M.D.

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1093973273
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2008-00757 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-6304
Phone
(336) 716-7243
Fax
(336) 716-7432
NPI assigned
May 25, 2008
Last updated
Nov 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101247675 VA
Diagnostic Radiology Physician 2085R0202X 200800757 NC
Diagnostic Radiology Physician 2085R0202X 2008-00757 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-6304

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-7243

Other identifiers 1

IdentifierTypeStateIssuer
5910947MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090224000374 NC Practitioner - Diagnostic Radiology 3476618596 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
State University of New York Downstate Medical Center, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Health Network LLCGroup PAC ID 4183538895, 276 clinicians
Wake Forest Baptist Imaging LLCGroup PAC ID 3173681681, 76 clinicians

Practice addresses (Care Compare)

1814 Westchester Dr
Suite 100
High Point, NC 27262-7369
Phone (336) 802-2175

265 Executive Park Blvd
Winston Salem, NC 27103-1503
Phone (336) 765-5722

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200800757NCMDDiagnostic Radiology Physician
0101247675VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jun 1, 2015 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jan 1, 2014 Accepting new patients
Diagnostic Radiology & Imaging LLC Diagnostic Radiology CurrentSince Jul 1, 2011 Accepting new patients
Wake Forest Health Network LLC Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 1, 2011 Accepting new patients
Triad Radiology Associates, PLLC CurrentSince Jul 1, 2008 Accepting new patients
Wake Forest Health Network LLC Current Accepting new patients
Triad Radiology Associates PLLC Diagnostic Radiology CurrentSince Jul 1, 2008 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jun 1, 2015 Accepting new patients
Greensboro Radiology, PA Diagnostic Radiology CurrentSince Jul 1, 2011 Accepting new patients
Wake Forest Baptist Imaging LLC Diagnostic Radiology CurrentSince Sep 27, 2024 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 1, 2011 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Jun 1, 2015 Accepting new patients

Locations

223 W Ward St
#B
Asheboro, NC 27203

223 W Ward St
Ste B
Asheboro, NC 27203
Phone (336) 702-1731

364 White Oak St
Asheboro, NC 27203
Phone (336) 625-5151

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1331 N Elm St
Ste 200
Greensboro, NC 27401
Phone (336) 274-4285

315 W Wendover Ave
Greensboro, NC 27408
Phone (336) 273-0530

1814 Westchester Dr
Ste 100
High Point, NC 27262
Phone (336) 802-2397

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

830 Rockford St
Mount Airy, NC 27030
Phone (336) 719-7000

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: kbrozzetticronin2754207@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 5

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": "1211673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1093973273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-7243",
            "fax_number": "336-716-7432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271576304",
            "telephone_number": "336-716-7243",
            "fax_number": "336-716-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROZZETTI-CRONIN",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-25",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101247675",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200800757",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2008-00757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910947",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.