NPIMap

Organization Active NPI

Dilworth Facial Plastic Surgery, PLLC

  • Facial Plastic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1376917633
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
2013-00940 Issued in NC
Legal business name
DILWORTH FACIAL PLASTIC SURGERY, PLLC
Practice address
1819 Lyndhurst Ave
Charlotte, NC 28203-5103
Phone
(980) 949-6544
Fax
(980) 422-0091
NPI assigned
Nov 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Authorized official

Name
Joshua B Surowitz, M.D.NPI 1700080678
Title
Co-Owner
Phone
(919) 619-0383

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X 2013-00940 NC
Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YS0123X 2013-00940 NC Primary
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0007X 2013-00940 NC
Plastic and Reconstructive Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0122X 2013-00940 NC

Addresses

Primary practice location

1819 Lyndhurst Ave
Charlotte, NC 28203-5103

Mailing address

1819 Lyndhurst Ave
Charlotte, NC 28203-5103
Phone (980) 949-6544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170322000471 NC Part B Supplier - Clinic/Group Practice 8921383597 Receives reassigned benefits from 3 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Tax ID family
Charlotte Facial Plastic Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1376917633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 LYNDHURST AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035103",
            "telephone_number": "980-949-6544",
            "fax_number": "980-422-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 LYNDHURST AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035103",
            "telephone_number": "980-949-6544",
            "fax_number": "980-422-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILWORTH FACIAL PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "SUROWITZ",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "919-619-0383",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "2013-00940",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "NC",
            "license": "2013-00940",
            "primary": true
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "NC",
            "license": "2013-00940",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NC",
            "license": "2013-00940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.