Individual provider Active NPI

Ivy P Altomare, MD

  • Hematology & Oncology Physician
  • Durham, NC
National Provider Identifier
1609063254
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2007-01408 Issued in NC
Practice address
40 Duke Medicine Cir
Durham, NC 27710-4430
Phone
(919) 684-8111
NPI assigned
Sep 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 2007-01408 NC Primary

Addresses

Primary practice location

40 Duke Medicine Cir
Durham, NC 27710-4430

Mailing address

5213 S Alston Ave
Durham, NC 27713-4430
Phone (919) 684-8111

Other identifiers 1

IdentifierTypeStateIssuer
5907862MedicaidNC

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
I20071004000464 NC Practitioner - Hematology/Oncology 9537254636 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-01408NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johnston Specialty Physician Services,Inc Current Accepting new patients
DLP Maria Parham Physician Practices LLC CurrentSince Oct 1, 2014 Accepting new patients
DLP Maria Parham Physician Practices, LLC Current Accepting new patients
Johnston Specialty Physician Services,Inc Hematology & Oncology CurrentSince Mar 1, 2018 Accepting new patients
DLP Maria Parham Physician Practices, LLC CurrentSince Oct 1, 2014 Accepting new patients
Private Diagnostic Clinic, PLLC Past Accepting new patients

Locations

2076 Veterans Pkwy
Ste 130
Clayton, NC 27520

120 Charles Rollins Rd
Ste 105
Henderson, NC 27536
Phone (252) 438-2773

514 N Brightleaf Blvd
Ste 1100
Smithfield, NC 27577
Phone (919) 939-2192

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

514 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 209-3555

Interoperability endpoints

  • Direct secure messaging: ivy.altomare.1@20247.direct.athenahealth.com

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1609063254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5213 S ALSTON AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134430",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 DUKE MEDICINE CIR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277104430",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTOMARE",
        "first_name": "IVY",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2007-01408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907862",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.