Moses Cone Medical Services Inc.
Organization Active NPI Ambulatory Surgical Clinic/Center · Greensboro, NC
NPI 1194744532 · NPPES record last updated Sep 30, 2014
Key facts
- NPI
- 1194744532
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- AS0052 (NC)
- Legal business name
- MOSES CONE MEDICAL SERVICES INC.
- Practice address
- 520 N Elam Ave
Greensboro, NC 27403-1127 - Phone
- (336) 547-1700
- NPI assigned
- Jul 18, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- THE MOSES H. CONE MEMORIAL HOSPITAL
Authorized official
- Name
- Mr. Robert Lee Goldstein
- Title
- Executive Vice President
- Phone
- (336) 832-6250
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 2
Practitioners 214
-
Alyssa Michelle Allwardt, PA-C
-
Steven Craig Altabet, PHD
-
Camille Lee Andy, MD
-
Karen Marghanita Aquino, M.D.
-
Steven Armbruster, M.D.
-
Lauren Elizabeth Autry, PHYSICIAN ASSISTANT
-
Peter Edward Babcock, ACNP
-
Shannon Renee Banks, M.D.
-
Gaytri Patel Barker, PSY.D.
-
Trevor Todd Barker, PSY.D.
-
Terri Woodford Bauert, MSW, LCSW
-
Mary John Baxley, MD
-
Taylor Bailey Beck, DNP, FNP-C
-
Amy Elizabeth Bedsole, M.D.
-
Stacey Blyth, M.D.
-
Nahosi Katongo Bowa, M.D.
-
Campbell Brown, PT, DPT
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Lebauer Endoscopy Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D1096202 | Lebauer Endoscopy Center | Certificate of waiver | Feb 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061004000048 | NC | Part B Supplier - Ambulatory Surgical Center | 2769395458 | Practice locations: Greensboro, NC |
| O20140416000469 | NC | Part B Supplier - Clinic/Group Practice | 2769395458 |
Receives reassigned benefits from 4 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Whitsett, NC; Summerfield, NC; Reidsville, NC; Oak Ridge, NC; Madison, NC; Kernersville, NC; High Point, NC; Greensboro, NC… |
National Provider Directory
- Part of
- Moses Cone Mem Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | AS0052 | NC | Yes |
Addresses
Primary practice location
520 N Elam Ave
Greensboro, NC 27403-1127
Mailing address
PO Box 405633
Atlanta, GA 30384-5633
Phone (336) 547-1877
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00642 | Other | NC | BCBS NC |
| 1194744532 | Medicaid | NC |
Other names
- LeBauer Endoscopy Center
Other providers in Greensboro, NC
- Moses Cone Affiliated Physicians, Inc.
- Moses Cone Affiliated Physicians, Inc.
- Moses Cone Affiliated Physicians, Inc.
- Moses Cone Health System
- Moses Cone Health System
- Moses Cone Medical Services, Inc.
- Moses Cone Medical Services, Inc.
- Moses Cone Physician Services Inc
- Moses Cone Physician Services Inc
- Moses Cone Physician Services, Inc
All providers in Greensboro, NC · Ambulatory Surgical Clinic/Center in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.