Individual provider Active NPI

Mary E Georoff, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Greensboro, NC
National Provider Identifier
1528046562
Registry record updated Jan 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
200501224 Issued in NC
Practice address
706 Green Valley Rd
Suite 104
Greensboro, NC 27408-7038
Phone
(336) 387-2500
Fax
(336) 387-2568
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 200501224 NC Primary

Addresses

Primary practice location

706 Green Valley Rd
Suite 104
Greensboro, NC 27408-7038

Mailing address

1256 Thayer Dr
Asheboro, NC 27205-4143
Phone (336) 387-2500

Other identifiers 2

IdentifierTypeStateIssuer
260797200MedicaidFL
1528046562MedicaidNC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151001003097 NC Practitioner - Pathology 5597774752 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Greensboro Pathology, LLCGroup PAC ID 1153315643, 18 clinicians

Practice addresses (Care Compare)

706 Green Valley Rd
Suite 104
Greensboro, NC 27408-7043
Phone (336) 387-2500

Hospital & facility affiliations

  • Randolph Hospital Hospital, Asheboro, NC, CCN 340123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200501224NCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles (5 of 7)

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Pathology Services, Inc. Anatomic Pathology & Clinical Pathology Current Accepting new patients
Greensboro Pathology, LLC CurrentSince Nov 1, 2015 Accepting new patients
Greensboro Pathology, LLC CurrentSince Nov 1, 2015 Accepting new patients
Ameripath Florida LLC Past Accepting new patients
Biopsy Diagnostics, LLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

706 Green Valley Rd
Ste 104
Greensboro, NC 27408
Phone (336) 271-4930

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

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 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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452556800000",
    "number": "1528046562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 THAYER DR",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272054143",
            "telephone_number": "336-387-2500",
            "fax_number": "336-387-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 GREEN VALLEY RD",
            "address_2": "SUITE 104",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087038",
            "telephone_number": "336-387-2500",
            "fax_number": "336-387-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEOROFF",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2016-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "200501224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260797200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528046562",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.