Michael Raymond Tamberella III, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

9800404 Issued in NC

Practice address

2555 Court Dr
Suite 200
Gastonia, NC 28054-2134

Phone

(704) 867-2141

Fax

(704) 867-2308

NPI assigned

Sep 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine

Education

Louisiana State University School of Medicine in New Orleans, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, shared by 2 NPIs, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Clover, SC
  • NPI 1568641165
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1245419845
  NPD (past)
• Lake Emergency Services Inc

  • Emergency Medicine Physician
  • Willoughby, OH
  • NPI 1518927995
  NPD (past)

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

• Gaston Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407801600000",
    "number": "1326035841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR",
            "address_2": "SUITE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542134",
            "telephone_number": "704-867-2141",
            "fax_number": "704-867-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMBERELLA",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2014-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "009800404",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "9800404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891364U",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0040G",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valeria Tabares Vivas
• Garyn Talbert, DC
• Kassandra Kitney Tallarico, OTR/L
• Davelyn Talley
• Lisa Leatherman Tallman, M.S. CF-SLP
• Anh Nguyen Viet Tang, PHARMD
• Jenny Tang, MS, CCC-SLP
• Miracle Tann, LCSW-A
• Austin C Tanner, BT
• Kelly Walton Tanner, FNP

• Interventional Cardiology Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Interventional Cardiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.