Individual provider Active NPI

Ann Gielyn Silva-Abueg Konzem, PA-C

  • Physician Assistant
  • Tarboro, NC
National Provider Identifier
1467800649
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2906 N Main St
Tarboro, NC 27886-1921
Phone
(252) 823-7212
NPI assigned
May 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 0010-07588 NC
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2906 N Main St
Tarboro, NC 27886-1921

Mailing address

1357 Holland Rd
Greenville, NC 27834-7976
Phone (951) 237-6506

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
I20180219002171 NC Practitioner - Physician Assistant 6406124692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

105 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7714

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-8585

2906 N Main St
Tarboro, NC 27886-1921
Phone (252) 823-7212

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53884CAMDPharmacist
0010-07588NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Feb 8, 2023 Accepting new patients
Vidant Medical Group LLC Single Specialty CurrentSince Feb 8, 2023 Accepting new patients

Locations

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

2906 N Main St
Tarboro, NC 27886
Phone (252) 443-0400

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.

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": "1464480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1467800649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 HOLLAND RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347976",
            "telephone_number": "951-237-6506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 N MAIN ST",
            "city": "TARBORO",
            "state": "NC",
            "postal_code": "278861921",
            "telephone_number": "252-823-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONZEM",
        "first_name": "ANN GIELYN",
        "middle_name": "SILVA-ABUEG",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-29",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07588",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarboro, NC

Sources for this page

Verify at the official NPI Registry.