Jason Michael Pesqueira, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2021-00488 Issued in NC

Practice address

1614 N Highway 56
Creedmoor, NC 27522-2752

Phone

(919) 575-6103

Fax

(919) 575-6817

NPI assigned

Apr 21, 2014

Sex

Male

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

Family Practice

Education

Florida State University College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Granville Health SystemGroup PAC ID 1052223757, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Granville Health Systems Hospital, Oxford, NC, CCN 340127

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jasonpesqueira@gvhs.allscriptsdirect.net

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.

• Granville Health System

  • Certified Registered Nurse Anesthetist
  • Oxford, NC
  • NPI 1275638512
  Medicare reassignment Care Compare group NPD
• Granville Health System

  • Diagnostic Radiology Physician
  • Oxford, NC
  • NPI 1104683341
  NPD
• Granville Health System

  • Hospitalist Physician
  • Oxford, NC
  • NPI 1629252986
  NPD
• Granville Health System

  • Rural Health Clinic/Center
  • Oxford, NC
  • NPI 1811999055
  NPD

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

• Granville Health System

  • General Acute Care Hospital
  • Oxford, NC
  • NPI 1326061730
  Care Compare affiliation

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1184044950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986",
            "city": "OXFORD",
            "state": "NC",
            "postal_code": "275650986",
            "telephone_number": "919-690-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 N HIGHWAY 56",
            "city": "CREEDMOOR",
            "state": "NC",
            "postal_code": "275222752",
            "telephone_number": "919-575-6103",
            "fax_number": "919-575-6817"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Child St",
            "address_2": "Family Medicine Clinic",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32214",
            "country_code": "US",
            "telephone_number": "850-356-1828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PESQUEIRA",
        "first_name": "JASON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "202100488",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-00488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Creedmoor, NC
• Providers in Creedmoor, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; 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.