NPIMap

Individual provider Active NPI

Mark Justin Hylarides, MD

  • Hospitalist Physician
  • North Wilkesboro, NC
National Provider Identifier
1285194662
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
2022-02050 Issued in NC
Practice address
1370 W D St
North Wilkesboro, NC 28659-3506
Phone
(336) 651-8100
Fax
(336) 716-0030
NPI assigned
Mar 22, 2019
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61200401 WA
Hospitalist Physician 208M00000X 2022-02050 NC Primary

Addresses

Primary practice location

1370 W D St
North Wilkesboro, NC 28659-3506

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 651-8100

Other practice location 1

9710 State Ave
Marysville, WA 98270-2232
Phone (360) 653-1742

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
I20220930002517 NC Practitioner - Hospitalist 8820474604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61200401WAMDFamily Medicine Physician
2022-02050NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2022 Accepting new patients

Locations

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

1917 W Park Dr
North Wilkesboro, NC 28659
Phone (336) 903-0147

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: mhylarides2754079@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: mhylarides450514@direct.multicare.org

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.

Hospital & facility affiliations 6

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1285194662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-651-8100",
            "fax_number": "336-716-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 W D ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286593506",
            "telephone_number": "336-651-8100",
            "fax_number": "336-716-0030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9710 State Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982702232",
            "country_code": "US",
            "telephone_number": "360-653-1742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HYLARIDES",
        "first_name": "MARK",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61200401",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2022-02050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.