Individual provider Active NPI

Deogracia Quinones, MD

  • Specialist
  • Fort Bragg, NC
National Provider Identifier
1629079926
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35729 Issued in NC
Practice address
Womack Army Medical Ctr
Stop a, 2817 Reilly Road
Fort Bragg, NC 28310-0001
Phone
(910) 907-8664
Fax
(910) 907-7762
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 35729 NC Primary
Urology Physician 208800000X 35729 NC

Addresses

Primary practice location

Womack Army Medical Ctr
Stop a, 2817 Reilly Road
Fort Bragg, NC 28310-0001

Mailing address

Womack Army Medical Ctr
Stop a, 2817 Reilly Road
Fort Bragg, NC 28310-0001
Phone (910) 907-8664

Other identifiers 1

IdentifierTypeStateIssuer
89131WRMedicaidNC

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
I20040807000246 NC Practitioner - Urology 7911979299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unc Physicians Network LLCGroup PAC ID 5496940546, 985 clinicians

Practice addresses (Care Compare)

815 Oakridge Blvd
Lumberton, NC 28358-2330
Phone (910) 738-7166

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35729NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Urology CurrentSince Aug 8, 2022 Accepting new patients
Unc Physicians Network LLC Current Accepting new patients

Locations

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

815 Oakridge Blvd
Lumberton, NC 28358
Phone (910) 738-7166

5221 Paramount Pkwy
Ste 220
Morrisville, NC 27560
Phone (984) 215-4110

Interoperability endpoints

  • Direct secure messaging: dquinones222474@direct.unc.nchie.net

Organizations & group practices 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1629079926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WOMACK ARMY MEDICAL CTR",
            "address_2": "STOP A, 2817 REILLY ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8664",
            "fax_number": "910-907-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WOMACK ARMY MEDICAL CTR",
            "address_2": "STOP A, 2817 REILLY ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8664",
            "fax_number": "910-907-7762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "DEOGRACIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "35729",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "35729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89131WR",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.