Active NPI
Tinsley Surgical, PA
- Vascular Surgery Physician
- Wilmington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- Legal business name
- TINSLEY SURGICAL, PA
- Practice address
- 1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019 - Phone
- (910) 399-6427
- Fax
- (910) 769-3531
- NPI assigned
- Dec 5, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ellis A Tinsley, MD
- Title
- Owner
- Phone
- (910) 769-2583
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | Primary |
Addresses
Primary practice location
1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019
Mailing address
1717 Shipyard Blvd Ste 200
Wilmington, NC 28403-8019
Phone (910) 769-2583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190115003386 | NC | Part B Supplier - Clinic/Group Practice | 2769728526 |
Receives reassigned benefits from 10 practitioners Practice locations: Wilmington, NC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D2206921 | Tinsley Surgical, PA | Certificate of waiver | Dec 22, 2026 |
National Provider Directory
National Provider DirectoryLocations
1717 Shipyard Blvd
Ste 210
Wilmington, NC 28403
Phone (910) 392-7877
1717 Shipyard Blvd
Ste 200
Wilmington, NC 28403
Phone (910) 452-8482
1801 S 17th St
Wilmington, NC 28401
Phone (910) 763-4555
Interoperability endpoints
- https://api.platform.athenahealth.com/22201/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 10
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": "1543968000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633996800000",
"number": "1407326291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 SHIPYARD BLVD STE 200",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038019",
"telephone_number": "910-769-2583",
"fax_number": "910-769-3531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 SHIPYARD BLVD STE 200",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038019",
"telephone_number": "910-399-6427",
"fax_number": "910-769-3531"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TINSLEY SURGICAL, PA",
"organizational_subpart": "NO",
"enumeration_date": "2018-12-05",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A",
"authorized_official_last_name": "TINSLEY",
"authorized_official_first_name": "ELLIS",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "910-769-2583",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.