Individual provider Active NPI

Michael Thomas Parrella

  • Medical Physician Assistant
  • Knightdale, NC
National Provider Identifier
1689145476
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
210 Hinton Oaks Blvd Ste E
Knightdale, NC 27545-6564
Phone
(919) 679-3177
NPI assigned
Dec 6, 2018
Reactivated
Nov 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

210 Hinton Oaks Blvd Ste E
Knightdale, NC 27545-6564

Mailing address

4705 University Dr BLDG 700
Durham, NC 27707-3489
Phone (919) 748-4899

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190411001787 NC Practitioner - Physician Assistant 1456692813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Brody School of Medicine at East Carolina University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

210 Hinton Oaks Blvd
Suite E
Knightdale, NC 27545-6564
Phone (919) 679-3177

7510 Ramble Way
Suite 107
Raleigh, NC 27616-4305
Phone (919) 747-3033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mtparrel@yourcarecommunity.org

Organizations & group practices 1

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": "1544054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1689145476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 UNIVERSITY DR BLDG 700",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277073489",
            "telephone_number": "919-748-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 HINTON OAKS BLVD STE E",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456564",
            "telephone_number": "919-679-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRELLA",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-06",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "deactivation_date": "2022-11-09",
        "reactivation_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

Verify at the official NPI Registry.