Organization Active NPI

Crystal Coast Cosmetic Care ENT Surgical Services, PLLC

  • Otolaryngology Physician
  • Cape Carteret, NC
National Provider Identifier
1346090065
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CRYSTAL COAST COSMETIC CARE ENT SURGICAL SERVICES, PLLC
Practice address
231 WB McLean Dr
Cape Carteret, NC 28584-8515
Phone
(252) 764-5414
NPI assigned
Mar 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Dr. David Christopher Roska, DONPI 1467551861
Title
PLLC Business Owner
Phone
(252) 503-8707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

231 WB McLean Dr
Cape Carteret, NC 28584-8515

Mailing address

101 Hope Town CT
Cedar Point, NC 28584-4501
Phone (252) 503-8707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250507000861 NC Part B Supplier - Clinic/Group Practice 1557888104 Receives reassigned benefits from 1 practitioner
Practice locations: Cape Carteret, NC

National Provider Directory

National Provider Directory

Locations

231 Wb McLean Dr
Cape Carteret, NC 28584
Phone (252) 764-5414

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1346090065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOPE TOWN CT",
            "city": "CEDAR POINT",
            "state": "NC",
            "postal_code": "285844501",
            "telephone_number": "252-503-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 WB MCLEAN DR",
            "city": "CAPE CARTERET",
            "state": "NC",
            "postal_code": "285848515",
            "telephone_number": "252-764-5414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL COAST COSMETIC CARE ENT SURGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A",
        "authorized_official_last_name": "ROSKA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PLLC BUSINESS OWNER",
        "authorized_official_telephone_number": "252-503-8707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Carteret, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.