Individual provider Active NPI

Tina Eun Sprouse, MD

  • Diagnostic Radiology Physician
  • Raleigh, NC
National Provider Identifier
1336375047
Registry record updated Apr 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2018-00902 Issued in NC
Practice address
3949 Browning PL
Raleigh, NC 27609-6536
Phone
(919) 787-7411
Fax
(919) 789-4461
NPI assigned
Jun 9, 2009
Sex
Female
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
Diagnostic Radiology Physician 2085R0202X MD042344 DC
Diagnostic Radiology Physician 2085R0202X 2018-00902 NC Primary

Addresses

Primary practice location

3949 Browning PL
Raleigh, NC 27609-6536

Mailing address

3949 Browning PL
Raleigh, NC 27609-6536
Phone (919) 787-7411

Other practice location 1

110 Irving St NW
Dept. of Radiology
Washington, DC 20010-3017
Phone (202) 877-7000

Other names 1

  • Tina Eun Lee Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180614001401 NC Practitioner - Diagnostic Radiology 0143541813 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Virginia School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Radiology Consultants PAGroup PAC ID 4385537992, 59 clinicians
Wake Radiology Diagnostic Imaging Inc.Group PAC ID 5092611863, 66 clinicians

Practice addresses (Care Compare)

3949 Browning PL
Raleigh, NC 27609-6535

3949 Browning PL
Raleigh, NC 27609-6536
Phone (919) 787-7411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

Merit-based Incentive Payment System (MIPS)

Final score
85.29 of 100Reported as group
Quality
82.69
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD042344DCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Radiology Consultants PA Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients
Wake Radiology Diagnostic Imaging Inc. Diagnostic Radiology CurrentSince Jun 1, 2018 Accepting new patients

Locations

3949 Browning Pl
Raleigh, NC 27609
Phone (919) 787-8221

Interoperability endpoints

  • Direct secure messaging: tsprouse433617@direct.unc.nchie.net

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524787200000",
    "number": "1336375047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 BROWNING PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096536",
            "telephone_number": "919-787-7411",
            "fax_number": "919-789-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 BROWNING PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096536",
            "telephone_number": "919-787-7411",
            "fax_number": "919-789-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW",
            "address_2": "Dept. of Radiology",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPROUSE",
        "first_name": "TINA",
        "middle_name": "EUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-09",
        "last_updated": "2018-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DC",
            "license": "MD042344",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2018-00902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "LEE",
            "middle_name": "EUN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.