Individual provider Active NPI

Marta Bianco, PAC

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1164825568
Registry record updated Sep 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-12453 Issued in NC
Practice address
2800 Blue Ridge Rd Ste 300
Raleigh, NC 27607-6476
Phone
(919) 784-7874
NPI assigned
Sep 30, 2014
Last updated
Sep 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X 0010-12453 NC Primary

Addresses

Primary practice location

2800 Blue Ridge Rd Ste 300
Raleigh, NC 27607-6476

Mailing address

105 Solstice Cir
Cary, NC 27513-5230
Phone (718) 510-7972

Other names 1

  • Marta Ozga Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mbianco1062489@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150727000958 NY Practitioner - Physician Assistant 2769796358 Reassigns benefits to 1 organization
I20231009002856 NC Practitioner - Physician Assistant 2769796358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

4420 Lake Boone TRL
Raleigh, NC 27607-7505

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore-Lij Medical PC CurrentSince Apr 7, 2015 Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: mbianco1062489@direct.unc.nchie.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1412035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695427200000",
    "number": "1164825568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SOLSTICE CIR",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275135230",
            "telephone_number": "718-510-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD STE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076476",
            "telephone_number": "919-784-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIANCO",
        "first_name": "MARTA",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-30",
        "last_updated": "2023-09-23",
        "certification_date": "2023-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-12453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbianco1062489@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2800 Blue Ridge Rd Ste 300",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTA",
            "last_name": "OZGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.