Individual provider Active NPI

Erfaan Ghiassi, MD

  • Family Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1568027639
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2022-01183 Issued in NC
Practice address
105 Vest Mill Cir
Winston Salem, NC 27103-2943
Phone
(336) 718-7800
Fax
(336) 718-7900
NPI assigned
May 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2022-01183 NC Primary

Addresses

Primary practice location

105 Vest Mill Cir
Winston Salem, NC 27103-2943

Mailing address

PO Box 751803
Charlotte, NC 28275-1803

Other practice location 1

4070 Highway 17
Murrells Inlet, SC 29576-5033
Phone (843) 652-1293

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
I20220809002151 NC Practitioner - Family Practice 1850723800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

100 Robinhood Medical PLZ
Winston Salem, NC 27106-5476
Phone (336) 718-0800

Hospital & facility affiliations

  • Medi Home Health & Hospice Home health agency, Thomasville, NC, CCN 347185
  • Bayada Home Health Care, Inc Home health agency, Winston-Salem, NC, CCN 347187
  • Novant Health Forsyth Medical Center Hospital, Winston-Salem, NC, CCN 340014

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forsyth Memorial Hospital, Inc. Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Forsyth Memorial Hospital, Inc Family Medicine Past Accepting new patients

Locations

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

100 Robinhood Medical Plz
Winston Salem, NC 27106
Phone (336) 718-0560

105 Vest Mill Cir
Winston Salem, NC 27103
Phone (336) 718-7800

Interoperability endpoints

  • Direct secure messaging: eghiassi1067963@direct.novanthealth.org

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 3

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": "1556928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1568027639",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VEST MILL CIR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271032943",
            "telephone_number": "336-718-7800",
            "fax_number": "336-718-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4070 Highway 17",
            "address_purpose": "LOCATION",
            "city": "Murrells Inlet",
            "state": "SC",
            "postal_code": "295765033",
            "country_code": "US",
            "telephone_number": "843-652-1293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHIASSI",
        "first_name": "ERFAAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-04",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2022-01183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.