Individual provider Active NPI

Abigail Sagar Plonk, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1265456420
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-00502 Issued in NC
Practice address
2020 N Peace Haven Rd
Winston Salem, NC 27106-4851
Phone
(336) 768-1280
Fax
(336) 760-8443
NPI assigned
Jul 27, 2006
Last updated
Jun 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-00502 NC Primary

Addresses

Primary practice location

2020 N Peace Haven Rd
Winston Salem, NC 27106-4851

Mailing address

2020 N Peace Haven Rd
Winston Salem, NC 27106-4851
Phone (336) 768-1280

Other identifiers 2

IdentifierTypeStateIssuer
0010-00502OtherNCSTATE LICENSE
1071581OtherNCNCCPA NUMBER

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070502000177 NC Practitioner - Physician Assistant 9739285172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westgate Dermatology and Laser Center, P.a.Group PAC ID 8325104714, 9 clinicians

Practice addresses (Care Compare)

2020 N Peace Haven Rd
Winston Salem, NC 27106-4851
Phone (336) 768-1280

2020 Peace Haven Rd
Winston Salem, NC 27106-4851

Merit-based Incentive Payment System (MIPS)

Final score
88.24 of 100Reported as group
Quality
100
Improvement activities
40
Cost
60.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1265456420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N PEACE HAVEN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064851",
            "telephone_number": "336-768-1280",
            "fax_number": "336-760-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N PEACE HAVEN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271064851",
            "telephone_number": "336-768-1280",
            "fax_number": "336-760-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLONK",
        "first_name": "ABIGAIL",
        "middle_name": "SAGAR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0010-00502",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA NUMBER",
            "identifier": "1071581",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.