Active NPI
Victor Marcel Gellineau III, M.D.
- Family Medicine Physician
- Raleigh, NC
National Provider Identifier
1184794331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2021-02186
- Practice address
- 4600 Capital Blvd
Raleigh, NC 27604-4478 - Phone
- (919) 980-7008
- Fax
- (919) 336-4528
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2021-02186 | NC | Primary |
| Family Medicine Physician | 207Q00000X | A75952 | CA |
Addresses
Primary practice location
4600 Capital Blvd
Raleigh, NC 27604-4478
Mailing address
PO Box 746724
Atlanta, GA 30374-6724
Phone (312) 733-9730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090709000551 | CA | Practitioner - Family Practice | 3072665751 | |
| I20210909001444 | NC | Practitioner - Family Practice | 3072665751 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.11 of 100
- Quality
- 86.24
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 78.35
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A75952 | CA | MD | Family Medicine Physician |
| 2021-02186 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osh-Mi Physicians Group PC | Family Medicine | Current | Accepting new patients |
| Osh Mi Physicians Group, PC | Current | Accepting new patients | |
| Regents of the Univ of Ca | Past | Accepting new patients |
Locations
3250 Freedom Dr
Charlotte, NC 28208
Phone (704) 394-0118
4600 Capital Blvd
Raleigh, NC 27604
Phone (919) 336-4528
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.
-
- Family Medicine Physician
- Greensboro, NC
- NPI 1033766092
Family Medicine, NC
-
- Primary Care Clinic/Center
- Memphis, TN
- NPI 1720635790
-
- Orthopaedic Surgery Physician
- Sacramento, CA
- NPI 1275526295
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1184794331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746724",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746724",
"telephone_number": "312-733-9730",
"fax_number": "773-866-8014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 CAPITAL BLVD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276044478",
"telephone_number": "919-980-7008",
"fax_number": "919-336-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELLINEAU",
"first_name": "VICTOR",
"middle_name": "MARCEL",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2021-02186",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A75952",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.