Individual provider Active NPI

Brian Wayne Paitsel, M.D.

  • Anesthesiology Physician
  • Winston Salem, NC
National Provider Identifier
1134256134
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
121897 Issued in NC
Practice address
Medical Center Blvd
Winston-Salem, NC 27157
Phone
(336) 716-2011
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 121897 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston-Salem, NC 27157

Mailing address

PO Box 344
Winston Salem, NC 27102-0344

Other identifiers 1

IdentifierTypeStateIssuer
5909607MedicaidNC

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
I20080710000520 NC Practitioner - Anesthesiology 8820160674 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121897NCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Center of Greensboro, LLC Current Accepting new patients
Gate City Anesthesia, Inc Anesthesiology CurrentSince Jul 13, 2009 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

1211 Virginia St
Greensboro, NC 27401
Phone (336) 272-0012

705 Green Valley Rd
Greensboro, NC 27408
Phone (336) 272-0012

21A Oak Branch Dr
Greensboro, NC 27407
Phone (336) 478-2664

21 Oak Branch Dr
#A
Greensboro, NC 27407

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1134256134",
    "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"
        },
        {
            "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": "27157",
            "telephone_number": "336-716-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAITSEL",
        "first_name": "BRIAN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "121897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909607",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.