Individual provider Active NPI

Keiko Marie Depasquale, DO

  • Obstetrics & Gynecology Physician
  • Raleigh, NC
National Provider Identifier
1639670060
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2021-03424 Issued in NC
Practice address
2615 Lake Dr Ste 201
Raleigh, NC 27607-6694
Phone
(919) 781-9555
NPI assigned
Feb 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2021-03424 NC Primary

Addresses

Primary practice location

2615 Lake Dr Ste 201
Raleigh, NC 27607-6694

Mailing address

2615 Lake Dr Ste 201
Raleigh, NC 27607-6694

Other names 1

  • Keiko Wadsworth Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://arbor-obgyn.com/ Direct

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
I20220810000724 NC Practitioner - Obstetrics/Gynecology 3678821295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Campbell Univ School of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Uwh of the Carolinas PLLCGroup PAC ID 0042448169, 329 clinicians

Practice addresses (Care Compare)

2615 Lake Dr
Suite 201
Raleigh, NC 27607-6694
Phone (919) 781-9555

Merit-based Incentive Payment System (MIPS)

Final score
88.25 of 100Reported as group
Quality
82.32
Promoting interoperability
100
Improvement activities
40
Cost
78.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-03424NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uwh of the Carolinas, PLLC Obstetrics & Gynecology CurrentSince Aug 1, 2022 Accepting new patients
Whap, PA Obstetrics & Gynecology Past Accepting new patients

Locations

2615 Lake Dr
Ste 201
Raleigh, NC 27607
Phone (919) 781-9555

1806 S Hawthorne Rd
Winston Salem, NC 27103
Phone (336) 768-3632

Interoperability endpoints

  • Direct secure messaging: keiko.depasquale.1@7773.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1639670060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 LAKE DR STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 LAKE DR STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076694",
            "telephone_number": "919-781-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPASQUALE",
        "first_name": "KEIKO",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2021-03424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://arbor-obgyn.com/",
            "affiliation": "N",
            "endpointDescription": "Practice Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Practice information",
            "address_1": "2615 Lake Dr Ste 201",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KEIKO",
            "last_name": "WADSWORTH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.