Active NPI
Carlos X Pimentel, MD
- Cardiovascular Disease Physician
- Winston Salem, NC
National Provider Identifier
1467457879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 2021-01859
- Practice address
- 186 Kimel Park Dr
Winston Salem, NC 27103-6946 - Phone
- (336) 277-2000
- Fax
- (336) 277-2050
- NPI assigned
- Jun 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | J8088 | TX | |
| Interventional Cardiology Physician | 207RI0011X | 2021-01859 | NC | |
| Interventional Cardiology Physician | 207RI0011X | J8088 | TX | |
| Cardiovascular Disease Physician | 207RC0000X | 2021-01859 | NC | Primary |
Addresses
Primary practice location
186 Kimel Park Dr
Winston Salem, NC 27103-6946
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-2000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037879602 | Medicaid | TX | |
| 060036091 | Other | TX | MEDICARE RAILROAD |
| 80E929 | Other | TX | BCBS |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021-01859 | NC | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Mint Hill Medical Center, LLC | Current | Accepting new patients | |
| McAllen Hospitals L P | Past | Accepting new patients | |
| Juan Joel Garza, MD PA | Cardiovascular Disease | Past | Accepting new patients |
Locations
8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000
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.
-
dba Professional Fees
- Certified Registered Nurse Anesthetist
- Charlotte, NC
- NPI 1063910404
-
- Cardiovascular Disease Physician
- Harlingen, TX
- NPI 1174642698
-
dba South Texas Health System - Heart
- Cardiac Rehabilitation Clinic/Center
- McAllen, TX
- NPI 1043849425
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1467457879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751803",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751803",
"telephone_number": "336-277-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "186 KIMEL PARK DR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271036946",
"telephone_number": "336-277-2000",
"fax_number": "336-277-2050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIMENTEL",
"first_name": "CARLOS",
"middle_name": "X",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-14",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "J8088",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "NC",
"license": "2021-01859",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "TX",
"license": "J8088",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NC",
"license": "2021-01859",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "037879602",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "060036091",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "80E929",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.