Individual provider Active NPI

Sabina Custovic, D.O.

  • Internal Medicine Physician
  • Greensboro, NC
National Provider Identifier
1649706367
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101023564 Issued in MI
Practice address
1910 N Church St Ste a
Greensboro, NC 27405-5665
Phone
(609) 992-6622
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 5101023564 MI Primary

Addresses

Primary practice location

1910 N Church St Ste a
Greensboro, NC 27405-5665

Mailing address

1910 N Church St Ste a
Greensboro, NC 27405-5665
Phone (609) 992-6622

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
I20230815001327 NC Practitioner - Cardiovascular Disease (Cardiology) 4880087824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Michigan Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

1234 Huffman Mill Rd
Burlington, NC 27215-8700
Phone (919) 684-8111

Hospital & facility affiliations

  • Alamance Regional Medical Center Hospital, Burlington, NC, CCN 340070

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Piedmont Cardiovascular, P.a. CurrentSince Aug 2, 2023 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital PastSince May 24, 2020 Accepting new patients

Locations

1234 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-1234

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

1910 N Church St
Ste A
Greensboro, NC 27405
Phone (336) 676-4388

101 Medical Park Dr
Mebane, NC 27302
Phone (336) 538-1234

Interoperability endpoints

  • Direct secure messaging: scustovic584725@direct.medicine.duke.edu
  • Direct secure messaging: scustovic428064@direct.hfhs.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 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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1649706367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 N CHURCH ST STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055665",
            "telephone_number": "609-992-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 N CHURCH ST STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274055665",
            "telephone_number": "609-992-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTOVIC",
        "first_name": "SABINA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101023564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.