Individual provider Active NPI

Marc Colaco

  • Urology Physician
  • Winston Salem, NC
National Provider Identifier
1467872291
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
2021-00390 Issued in NC
Practice address
Wake Forest Baptist Hospital
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(908) 230-6698
NPI assigned
Apr 19, 2014
Last updated
Aug 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 2021-00390 NC Primary
Pediatric Urology Physician 2088P0231X 2021-00390 NC

Addresses

Primary practice location

Wake Forest Baptist Hospital
Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

140 Charlois Blvd
Winston Salem, NC 27103-1522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20200311000106 PA Practitioner - Urology 8628398708 Reassigns benefits to 1 organization
I20210916003397 NC Practitioner - Urology 8628398708 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Charlois Blvd
Winston Salem, NC 27103-1522
Phone (336) 716-4131

3903 N Elm St
Greensboro, NC 27455-2594
Phone (336) 713-4944

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 9, 2021 Accepting new patients
University of Pittsburgh Physicians CurrentSince Feb 1, 2020 Accepting new patients
University of Pittsburgh Physicians CurrentSince Feb 1, 2020 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Piedmont Stone Center PLLC Urology CurrentSince Sep 23, 2021 Accepting new patients

Locations

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

140 Charlois Blvd
Winston Salem, NC 27103
Phone (336) 716-4131

1907 S Hawthorne Rd
Winston Salem, NC 27103

3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

300 Halket St
Ste 5200
Pittsburgh, PA 15213
Phone (412) 641-7850

3600 Forbes Ave
Ste 140
Pittsburgh, PA 15213

4401 Penn Ave
Pittsburgh, PA 15224
Phone (412) 692-5030

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1397865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1467872291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 CHARLOIS BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAKE FOREST BAPTIST HOSPITAL",
            "address_2": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "908-230-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLACO",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-19",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "2021-00390",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "NC",
            "license": "2021-00390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.