NPIMap

Individual provider Active NPI

Michael Charles Depasquale, PA

  • Physician Assistant
  • Reidsville, NC
National Provider Identifier
1104338094
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07528 Issued in NC
Practice address
1818 Richardson Dr Ste a
Reidsville, NC 27320-5450
Phone
(336) 349-5040
NPI assigned
Oct 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-07528 NC Primary

Addresses

Primary practice location

1818 Richardson Dr Ste a
Reidsville, NC 27320-5450

Mailing address

1818 Richardson Dr Ste a
Reidsville, NC 27320-5450
Phone (336) 349-5040

Other practice location 1

1000 Blythe Blvd Bldg 3
Charlotte, NC 28203-5812
Phone (360) 607-6175

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
I20171218001141 NC Practitioner - Physician Assistant 0840558078 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

718 Ridge Rd
Roxboro, NC 27573-4508
Phone (919) 603-1665

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030
  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Maria Parham Physician Practices, LLC CurrentSince Apr 13, 2020 Accepting new patients
DLP Person Physician Practices LLC CurrentSince May 18, 2020 Accepting new patients
DLP Person Urgent Care LLC CurrentSince Apr 13, 2020 Accepting new patients
Duke Health Integrated Practice, Inc CurrentSince Jul 1, 2023 Accepting new patients
DLP Person Physician Practices, LLC CurrentSince May 18, 2020 Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Apr 13, 2020 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Unc Physicians Network LLC Past Accepting new patients
DLP Maria Parham Physician Practices, LLC Past Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

566 Ruin Creek Rd
Henderson, NC 27536
Phone (252) 436-1352

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

568 Ruin Creek Rd
Ste 128
Henderson, NC 27536
Phone (252) 436-1085

1501 N Bickett Blvd
Ste E
Louisburg, NC 27549
Phone (919) 497-0445

1209 SE Industry Dr
Oxford, NC 27565
Phone (252) 492-8576

601 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

3762 Durham Rd
Ste A
Roxboro, NC 27573
Phone (336) 330-0400

Interoperability endpoints

  • Direct secure messaging: michael.depasquale.1@20247.direct.athenahealth.com
  • Direct secure messaging: mdepasquale274615@direct.medicine.duke.edu

Organizations & group practices 12

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 7

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": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104338094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 RICHARDSON DR STE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205450",
            "telephone_number": "336-349-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 RICHARDSON DR STE A",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273205450",
            "telephone_number": "336-349-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "360-607-6175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPASQUALE",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, NC

Sources for this page

Verify at the official NPI Registry.