Individual provider Active NPI

Bryan Edmund Stanislaus, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1457381535
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
120 William Penn PLZ
Durham, NC 27704-2150
Phone
(919) 220-5255
Fax
(919) 313-1276
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

120 William Penn PLZ
Durham, NC 27704-2150

Mailing address

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120503000389 NC Practitioner - Physician Assistant 8628083839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

3100 Duraleigh Rd
Suite 100
Raleigh, NC 27612-8105
Phone (919) 788-8797

7810 NC Hwy 751
Durham, NC 27713-6850
Phone (919) 544-7270

799 Doctors CT
Roxboro, NC 27573-4571
Phone (336) 599-4079

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001717CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA Physician Assistant CurrentSince Mar 12, 2012 Accepting new patients
Emergeortho PA CurrentSince Mar 12, 2012 Accepting new patients
United Hospital Center Inc Past Accepting new patients
Saint Raphael Faculty Physicians Physician Assistant Past Accepting new patients

Locations

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: bryan.stanislaus.1@847.direct.athenahealth.com

Organizations & group practices 4

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.

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1457381535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANISLAUS",
        "first_name": "BRYAN",
        "middle_name": "EDMUND",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.