Individual provider Active NPI

Amy Lenfestey Gagnon, M.D.

  • Dermatology Physician
  • Cary, NC
National Provider Identifier
1386901684
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101260451 Issued in VA
Practice address
110 Preston Executive Dr Ste 108
Cary, NC 27513-8447
Phone
(919) 653-1344
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101260451 VA Primary

Addresses

Primary practice location

110 Preston Executive Dr Ste 108
Cary, NC 27513-8447

Mailing address

PO Box 16536
Chapel Hill, NC 27516-6536
Phone (919) 653-1344

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
I20181218002802 NC Practitioner - Dermatology 9739317280 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Brody School of Medicine at East Carolina University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dermatology Center PAGroup PAC ID 8123006947, 31 clinicians

Practice addresses (Care Compare)

110 Preston Executive Dr
Suite 108
Cary, NC 27513-8447
Phone (919) 653-1344

Merit-based Incentive Payment System (MIPS)

Final score
92.77 of 100Reported as group
Quality
82.92
Promoting interoperability
100
Improvement activities
40
Cost
92.99

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions705
Removal or shaving of skin growth41
Skin biopsy252

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dermatology Center, PA Dermatology CurrentSince Jan 7, 2019 Accepting new patients
Skin Surgery Center PA Dermatology Past Accepting new patients

Locations

110 Preston Executive Dr
Ste 100
Cary, NC 27513
Phone (919) 653-1344

110 Preston Executive Dr
Ste 108
Cary, NC 27513
Phone (919) 653-1344

2238 Nelson Hwy
Ste 100
Chapel Hill, NC 27517
Phone (919) 282-5534

1301 Castlepointe Dr
Fuquay Varina, NC 27526
Phone (984) 849-4328

855 East St
Pittsboro, NC 27312
Phone (919) 542-2731

1212 Cedarhurst Dr
Ste 102
Raleigh, NC 27609
Phone (919) 431-9911

1210 Central Dr
Sanford, NC 27330
Phone (919) 776-5286

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.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1386901684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16536",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275166536",
            "telephone_number": "919-653-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PRESTON EXECUTIVE DR STE 108",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275138447",
            "telephone_number": "919-653-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNON",
        "first_name": "AMY",
        "middle_name": "LENFESTEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101260451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.