Active NPI
Ibis Health Services - North Carolina, PLLC
- Internal Medicine Physician
- Raleigh, NC
National Provider Identifier
1265216873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- IBIS HEALTH SERVICES - NORTH CAROLINA, PLLC
- Practice address
- 176 Mine Lake CT Ste 100
Raleigh, NC 27615-6417 - Phone
- (908) 230-4612
- Fax
- (207) 401-2727
- NPI assigned
- Aug 23, 2023
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Dr. Piali De, PHD
- Title
- Ceo of Mso (Senscio Systems)
- Phone
- (617) 834-2853
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240228002993 | NC | Part B Supplier - Clinic/Group Practice | 0446695530 |
Receives reassigned benefits from 5 practitioners Practice locations: Raleigh, NC |
National Provider Directory
National Provider DirectoryLocations
176 Mine Lake Ct
#100
Raleigh, NC 27615
Phone (404) 428-7041
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
176 Mine Lake CT Ste 100
Raleigh, NC 27615-6417
Mailing address
215 Ayer Rd Unit 797
Harvard, MA 01451-5033
Phone (978) 635-9090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 23, 2023.
{
"created_epoch": "1692748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1692748800000",
"number": "1265216873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 AYER RD UNIT 797",
"city": "HARVARD",
"state": "MA",
"postal_code": "014515033",
"telephone_number": "978-635-9090",
"fax_number": "207-401-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "176 MINE LAKE CT STE 100",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156417",
"telephone_number": "908-230-4612",
"fax_number": "207-401-2727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IBIS HEALTH SERVICES - NORTH CAROLINA, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-23",
"last_updated": "2023-08-23",
"certification_date": "2023-08-23",
"status": "A",
"authorized_official_last_name": "DE",
"authorized_official_first_name": "PIALI",
"authorized_official_title_or_position": "CEO OF MSO (SENSCIO SYSTEMS)",
"authorized_official_telephone_number": "617-834-2853",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"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 Aug 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.