Individual provider Active NPI

Renu Jerath Seth, MD

  • Family Medicine Physician
  • Goldsboro, NC
National Provider Identifier
1568446789
Registry record updated Mar 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
153068-2 Issued in NY
Practice address
104 Adair Dr
Goldsboro, NC 27530-4516
Phone
(845) 901-6223
NPI assigned
Dec 1, 2005
Last updated
Mar 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 153068-2 NY
Family Medicine Physician 207Q00000X 153068-2 NY Primary
Internal Medicine Physician 207R00000X 153068-2 NY

Addresses

Primary practice location

104 Adair Dr
Goldsboro, NC 27530-4516

Mailing address

104 Adair Dr
Goldsboro, NC 27530-4516
Phone (845) 901-6223

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
I20150521002603 NC Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Allergy/Immunology 4082716840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Allergy/Immunology, Family Practice
Education
Other, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 Wayne Memorial Dr
Suite C
Goldsboro, NC 27534-2201
Phone (845) 901-6223

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20924NCMDPharmacist
153068-2NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Goldsboro Internal Medicine and Med-Spa PLLC Internal Medicine CurrentSince Sep 29, 2019 Accepting new patients

Locations

1600 Wayne Memorial Dr
Ste C
Goldsboro, NC 27534
Phone (845) 901-6223

Organizations & group practices 1

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 2

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": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1568446789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 ADAIR DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304516",
            "telephone_number": "845-901-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 ADAIR DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275304516",
            "telephone_number": "845-901-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SETH",
        "first_name": "RENU",
        "middle_name": "JERATH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NY",
            "license": "153068-2",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "153068-2",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "153068-2",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goldsboro, NC

Sources for this page

Verify at the official NPI Registry.