Individual provider Active NPI

Melissa A. Carlucci, M.D.

  • Pediatric Endocrinology Physician
  • Raleigh, NC
National Provider Identifier
1386608404
Registry record updated Feb 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
46856 Issued in TN
Practice address
23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone
(919) 350-7584
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 055477 GA
Pediatric Endocrinology Physician 2080P0205X 2016-00107 NC
Pediatric Endocrinology Physician 2080P0205X 46856 TN Primary

Addresses

Primary practice location

23 Sunnybrook Rd
Raleigh, NC 27610-1855

Mailing address

2920 Highwoods Blvd
Raleigh, NC 27604-0010
Phone (877) 498-4490

Other identifiers 1

IdentifierTypeStateIssuer
943231345AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcarlucci113446@directHISP.wakemed.org Direct

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
I20160620001321 NC Practitioner - Pediatric MedicinePractitioner - Endocrinology 6103009667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
055477GAMDPediatric Endocrinology Physician
2016-00107NCMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Sep 15, 2019 Accepting new patients
Wakemed Specialists Group, LLC CurrentSince Sep 15, 2019 Accepting new patients

Locations

120 Healthplex Way
Apex, NC 27502
Phone (919) 235-6525

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

2920 Highwoods Blvd
Raleigh, NC 27604

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

Interoperability endpoints

  • Direct secure messaging: mcarlucci113446@directhisp.wakemed.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1386608404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 HIGHWOODS BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276040010",
            "telephone_number": "877-498-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-350-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLUCCI",
        "first_name": "MELISSA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "055477",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NC",
            "license": "2016-00107",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TN",
            "license": "46856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "943231345A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcarlucci113446@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "23 Sunnybrook Rd",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276101855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.