Active NPI
Samuel M Wesonga, MD
- Family Medicine Physician
- Raleigh, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 9300369
- Practice address
- 8001 T W Alexander Dr Ste 216
Raleigh, NC 27617-4884 - Phone
- (919) 350-0953
- Fax
- (193) 509-8189
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 93-00369 | NC | |
| Family Medicine Physician | 207Q00000X | 9300369 | NC | Primary |
Addresses
Primary practice location
8001 T W Alexander Dr Ste 216
Raleigh, NC 27617-4884
Mailing address
2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490
Other practice location 1
921 N. Winstead Avenue
Rocky Mount, NC 27804
Phone (252) 937-0300
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80084731 | Other | NC | RAILROAD MEDICARE |
| 8986588 | Medicaid | NC | |
| 59381 | Other | NC | MEDCOST |
| 86588 | Other | NC | BCBSNC |
| 5497949 | Other | NC | CIGNA HEALTHCARE |
Other names 1
- Sam Wesonga
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | swesonga236701@directHISP.wakemed.org | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Proactive Therapy of North Carolina Inc
Practice addresses (Care Compare)
2303 Wellington Dr SW
Suite B
Wilson, NC 27893-8620
Phone (252) 243-6818
8001 T W Alexander Dr
Raleigh, NC 27617-4883
Phone (919) 350-0953
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 93-00369 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wakemed Specialists Group, LLC | Current | Accepting new patients | |
| Wakemed Specialists Group LLC | Current | Accepting new patients | |
| Wakemed Specialists Group, LLC | Current | Accepting new patients | |
| Wake Specialty Physicians LLC | Current | Accepting new patients | |
| Wake Specialty Physicians, LLC | Current | Accepting new patients | |
| Boice-Willis Clinic PA | Family Medicine | Current | Accepting new patients |
| Wake Specialty Physicians, LLC | Family Medicine | Current | Accepting new patients |
Locations
222 Ashville Ave
Cary, NC 27518
Phone (919) 576-2330
231 N Judd Pkwy NE
Fuquay Varina, NC 27526
Phone (919) 235-6410
2920 Highwoods Blvd
Raleigh, NC 27604
8001 T W Alexander Dr
Ste 216
Raleigh, NC 27617
Phone (919) 350-0953
8001 T W Alexander Dr
Raleigh, NC 27617
Phone (919) 350-0953
10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630
10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380
10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300
3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000
250 Smith Church Rd
Roanoke Rapids, NC 27870
Phone (252) 308-9699
901 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0200
921 N Winstead Ave
Rocky Mount, NC 27804
Phone (252) 937-0300
2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199
Interoperability endpoints
- swesonga236701@directhisp.wakemed.org
Organizations & group practices 7
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.
-
- Cardiovascular Disease Physician
- Raleigh, NC
- NPI 1588227839
-
dba WakeMed Childrens Pediatric Primary Care - Fuquay-Varina Medical Park
- Pediatrics Physician
- Fuquay Varina, NC
- NPI 1578334892
-
dba WakeMed Urgent Care
- Urgent Care Clinic/Center
- Cary, NC
- NPI 1013297365
-
dba WakeMed - Virtual Cardiac Rehab
- Cardiac Rehabilitation Registered Nurse
- Raleigh, NC
- NPI 1063304228
-
- Gastroenterology Physician
- Raleigh, NC
- NPI 1356906705
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Nash General Hospital
- General Acute Care Hospital
- Rocky Mount, NC
- NPI 1619969219
-
dba WakeMed Mental Health & Well-Being Hospital WakeBrook
- Psychiatric Hospital Unit
- Raleigh, NC
- NPI 1780446302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618358400000",
"number": "1114911823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2920 HIGHWOODS BLVD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276040010",
"telephone_number": "877-498-4490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8001 T W ALEXANDER DR STE 216",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276174884",
"telephone_number": "919-350-0953",
"fax_number": "193-509-8189"
}
],
"practiceLocations": [
{
"address_1": "921 N. Winstead Avenue",
"address_purpose": "LOCATION",
"city": "Rocky Mount",
"state": "NC",
"postal_code": "27804",
"country_code": "US",
"telephone_number": "252-937-0300",
"fax_number": "252-937-2675",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WESONGA",
"first_name": "SAMUEL",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2021-04-14",
"certification_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "93-00369",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "9300369",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "80084731",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8986588",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "59381",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "86588",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA HEALTHCARE",
"identifier": "5497949",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "swesonga236701@directHISP.wakemed.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "xml",
"address_1": "8001 T W Alexander Dr Ste 216",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276174884",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SAM",
"last_name": "WESONGA",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.