Tony James Mezera, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

001002732 Issued in NC

Practice address

2153 Valleygate Dr
Suite 102
Fayetteville, NC 28304-3681

Phone

(910) 321-7246

Fax

(910) 321-7245

NPI assigned

Aug 23, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tony-mezera@ipcfayetteville.e-mdsdirect.com

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.

• Interventional Pain Center PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Fayetteville, NC
  • NPI 1558428789
  NPD

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408320000000",
    "number": "1174803118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2153 VALLEYGATE DR",
            "address_2": "SUITE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043681",
            "telephone_number": "910-321-7246",
            "fax_number": "910-321-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2153 VALLEYGATE DR",
            "address_2": "SUITE 102",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043681",
            "telephone_number": "910-321-7246",
            "fax_number": "910-321-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEZERA",
        "first_name": "TONY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-23",
        "last_updated": "2014-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001002732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walson Kehinde Metzger, MD
• Faatihah Meunier
• Kathryn Ann Meurer, PAC
• Eileen Marie Meyer, CRNA
• Bryce Kendall Meyers, D.O.,
• Mga Behavior Therapy LLC
• Mga Home Healthcare Fayetteville, LLC
• MGG Imaging
• Robin Michael, PHARMD
• Michaels World

• Medical Physician Assistant in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.