NPIMap

Individual provider Active NPI

Johny Denis Ardeljan, DO

  • Neurology Physician
  • Wilmington, NC
National Provider Identifier
1265692073
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2018-00949 Issued in NC
Practice address
1202 Medical Center Dr
Wilmington, NC 28401-7307
Phone
(910) 341-3300
Fax
(910) 251-2067
NPI assigned
Jun 16, 2008
Last updated
Apr 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2538571 NY
Neurology Physician 2084N0400X 2018-00949 NC Primary

Addresses

Primary practice location

1202 Medical Center Dr
Wilmington, NC 28401-7307

Mailing address

170 Great Neck Rd
Great Neck, NY 11021-3357
Phone (516) 487-4464

Other practice location 1

170 Great Neck Rd
Great Neck, NY 11021-3357
Phone (516) 487-4464

Other practice location 2

8090 Market St
Wilmington, NC 28411-9384
Phone (910) 341-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522001512 NC Practitioner - Neurology 8628262813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
New York College of Osteo Medicine of New York Institute of Technology, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Practice addresses (Care Compare)

1202 Medical Ctr Dr
Wilmington, NC 28401-7307
Phone (910) 341-1540

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2018-00949NCMDNeurology Physician
2538571NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington ASC LLC CurrentSince May 1, 2018 Accepting new patients
Wilmington Health PLLC CurrentSince May 1, 2018 Accepting new patients

Locations

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

8090 Market St
Wilmington, NC 28411
Phone (910) 251-6737

Interoperability endpoints

  • Direct secure messaging: john.ardeljan.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1265692073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 GREAT NECK RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213357",
            "telephone_number": "516-487-4464",
            "fax_number": "516-487-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-341-3300",
            "fax_number": "910-251-2067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Great Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110213357",
            "country_code": "US",
            "telephone_number": "516-487-4464",
            "fax_number": "516-487-4950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8090 Market St",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284119384",
            "country_code": "US",
            "telephone_number": "910-341-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARDELJAN",
        "first_name": "JOHNY",
        "middle_name": "DENIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "2538571",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2018-00949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.