Central Triad Retina, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

CENTRAL TRIAD RETINA, PA

Practice address

3333 Brookview Hills Blvd Ste 107
Winston Salem, NC 27103-5661

Phone

(336) 970-5900

Fax

(336) 842-3964

NPI assigned

Nov 17, 2015

Organization subpart

No

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

Authorized official

Name

Brandy Pressley

Title

Practice Administrator

Phone

(336) 970-5900

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: bkosobucki@ctrcare.intellechartdirect.net

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian R Kosobucki, M.D.

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1366548174
  Medicare reassignment NPD

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705276800000",
    "number": "1689048423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD",
            "address_2": "SUITE 107",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BROOKVIEW HILLS BLVD STE 107",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035661",
            "telephone_number": "336-970-5900",
            "fax_number": "336-842-3964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TRIAD RETINA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-15",
        "status": "A",
        "authorized_official_last_name": "PRESSLEY",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-970-5900"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Centerwell Certified Healthcare Corp. (CenterWell Home Health)
• Centerwell Senior Primary Care (NC), P.C. (CenterWell Senior Primary Care (NC), P.C. - Easton)
• Central Carolina Audiological Associates Inc
• Central Piedmont Access II
• Central Piedmont Retina
• Christina Un Cepeda-Chyr, PA-C
• Anthony Samuel Ceraulo, D.O.
• Jennifer Luzia Cerny, MS, NP-C
• Certus Psychiatry and Integrated Care PLLC (Cpic)
• Domenic Cetrone

• Ophthalmology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.