Maryellen Dolat Pace, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

2019-00623 Issued in NC

Practice address

509 N Elam Ave FL 2
Greensboro, NC 27403-1157

Phone

(336) 274-1114

Fax

(336) 274-9638

NPI assigned

May 6, 2011

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Urology

Education

Virginia Commonwealth University, School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Stone Center PLLCGroup PAC ID 2961315718, 71 clinicians

Urology Specialists of the Carolinas PLLCGroup PAC ID 0648178020, 78 clinicians

Alliance Urology SpecialistsGroup PAC ID 8921902586, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Moses H. Cone Memorial Hospital, the Hospital, Greensboro, NC, CCN 340091

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Piedmont Stone Center PLLC

  • Lithotripsy Clinic/Center
  • Winston Salem, NC
  • NPI 1700827409

  Urology

  Medicare reassignment Care Compare group NPD
• Urology Specialists of the Carolinas PLLC

  • Urology Physician
  • Greensboro, NC
  • NPI 1346204088
  Medicare reassignment Care Compare group NPD
• Urology Specialists of the Carolinas PLLC

  • Urology Physician
  • Charlotte, NC
  • NPI 1669404208
  Medicare reassignment Care Compare group NPD
• Moses Cone Physician Services Inc

  dba Reidsville Endocrinology Associates

  • Endocrinology, Diabetes & Metabolism Physician
  • Reidsville, NC
  • NPI 1780004556
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Moses H. Cone Memorial Hospital Operating Corporation

  • General Acute Care Hospital
  • Greensboro, NC
  • NPI 1477591055
  Care Compare affiliation

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1134411390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031157",
            "telephone_number": "336-274-1114",
            "fax_number": "336-274-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N ELAM AVE FL 2",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031157",
            "telephone_number": "336-274-1114",
            "fax_number": "336-274-9638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St",
            "address_2": "SURG: General - Surgery ACC",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-828-7391",
            "fax_number": "804-828-0191",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "MARYELLEN",
        "middle_name": "DOLAT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-06",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2019-00623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Waring Paa, PT
• Vonda Wardlaw Pabon, RN
• Brian M Pacanowski, PHARM. D.
• Pace of Guilford and Rockingham Counties, Inc (PACE of the Triad)
• Collier Stephens Pace, MD
• Sarah Pace
• Trista Leigh Pachan, PHARMD
• Karina M Paci, MD
• Shaylar Padgett
• Jana Alexis Padilla, DNP, APRN, CPNP-PC

• Urology Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Urology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.

Verify at the official NPI Registry.