Active NPI
Peter Hao-Hsiang Pan, MD
- Anesthesiology Physician
- Winston Salem, NC
National Provider Identifier
1124003256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2001 01585
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- NPI assigned
- Dec 13, 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 |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 200101585 | NC | |
| Anesthesiology Physician | 207L00000X | 2001 01585 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89130NJ | Medicaid | NC |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001 01585 | NC | MD | Anesthesiology Physician |
| 200101585 | NC | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- ppan2753020@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504828800000",
"number": "1124003256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255"
},
{
"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": "271570001",
"telephone_number": "336-716-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAN",
"first_name": "PETER",
"middle_name": "HAO-HSIANG",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-13",
"last_updated": "2017-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NC",
"license": "200101585",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "2001 01585",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89130NJ",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.