Individual provider Active NPI

Micheline Lataliza Epstein, M.D.

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1417245382
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2019-01497 Issued in NC
Practice address
4600 Lake Boone TRL Ste 200
Raleigh, NC 27607-7529
Phone
(919) 926-8890
NPI assigned
Jul 13, 2011
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 275648 NY
Family Medicine Physician 207Q00000X 2019-01497 NC Primary

Addresses

Primary practice location

4600 Lake Boone TRL Ste 200
Raleigh, NC 27607-7529

Mailing address

4600 Lake Boone TRL Ste 200
Raleigh, NC 27607-7529

Other identifiers 1

IdentifierTypeStateIssuer
00695941MedicaidNY

Other names 1

  • Dr. Micheline Lataliza McBrine Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150506000546 NY Practitioner - Family Practice 1153640594 Reassigns benefits to 6 organizations
I20200429001719 NC Practitioner - Family Practice 1153640594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronx Medical Practice PCGroup PAC ID 9739496100, 136 clinicians
Brain Health Medical PCGroup PAC ID 6709229073, 11 clinicians
LWB Associates PLLCGroup PAC ID 4789014077, 2 clinicians

Practice addresses (Care Compare)

14040 Sanford Ave
Flushing, NY 11355-2556
Phone (718) 299-7295

222 Broadway
Unit 2135
New York, NY 10038-2510
Phone (888) 818-2059

4600 Lake Boone TRL
Suite 210
Raleigh, NC 27607-7529

4601 Lake Boone TRL
Suite 2H
Raleigh, NC 27607-7530
Phone (919) 926-8890

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2019-01497NCMDFamily Medicine Physician
275648NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Oct 19, 2015 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Oct 19, 2015 Accepting new patients
Living Well Balanced Nyc Medical PLLC CurrentSince Jan 20, 2022 Accepting new patients
Bronx Medical Practice P.C. CurrentSince Jan 28, 2018 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Hbot LLC Current Accepting new patients
Essen Medical Associates,PC CurrentSince Jan 28, 2018 Accepting new patients
Essen Medical Associates, PC CurrentSince Jan 28, 2018 Accepting new patients
William F Ryan Community Health Center Inc Current Accepting new patients
House Call Medical Services of New York, PLLC CurrentSince May 1, 2020 Accepting new patients
LWB Associates PLLC CurrentSince Jun 19, 2019 Accepting new patients
Brain Health Medical PC CurrentSince Feb 5, 2024 Accepting new patients
Terence Cardinal Cooke Health Care Center Past Accepting new patients

Locations (25 of 27)

4600 Lake Boone Trl
Ste 210
Raleigh, NC 27607
Phone (919) 678-3286

4601 Lake Boone Trl
Ste 2H
Raleigh, NC 27607
Phone (919) 926-8890

1009 E 163rd St
Bronx, NY 10459
Phone (718) 828-6800

1181 Grand Concourse
Bronx, NY 10452
Phone (718) 457-7443

1371 Seabury Ave
Bronx, NY 10461
Phone (718) 294-6200

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1990 McGraw Ave
Ste A
Bronx, NY 10462

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2015 Grand Concourse
#13202
Bronx, NY 10453

2308 Eastchester Rd
Bronx, NY 10469

2445 Arthur Ave
Bronx, NY 10458
Phone (718) 220-3434

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

2722 White Plains Rd
Ste A
Bronx, NY 10467

2742 3rd Ave
Ste A
Bronx, NY 10455

305 E 149th St
Bronx, NY 10451
Phone (212) 470-9229

3130 Grand Concourse
Ste 1N
Bronx, NY 10458
Phone (718) 365-0892

3134 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1000

502 E Tremont Ave
Bronx, NY 10457
Phone (646) 762-6905

5997 Riverdale Ave
Bronx, NY 10471
Phone (718) 884-9803

616 Castle Hill Ave
Ste A
Bronx, NY 10473

918 Pelham Pkwy S
Ste 1
Bronx, NY 10462

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

1249 5th Ave
New York, NY 10029
Phone (212) 360-1000

180 W 80th St
New York, NY 10024
Phone (212) 579-2858

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1417245382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LAKE BOONE TRL STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 LAKE BOONE TRL STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077529",
            "telephone_number": "919-926-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "MICHELINE",
        "middle_name": "LATALIZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "275648",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2019-01497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00695941",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELINE",
            "last_name": "MCBRINE",
            "middle_name": "LATALIZA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.