Thomas J Braza, MD

Individual provider Active NPI MOHS-Micrographic Surgery Physician · Leland, NC

NPI 1699883124 · NPPES record last updated Nov 1, 2021

Key facts

NPI
1699883124
Entity type
Individual (NPI type 1)
Primary specialty
MOHS-Micrographic Surgery Physician 207ND0101X
License
2012-00516 (NC)
Practice address
144 Poole Rd Ste 101
Leland, NC 28451-9504
Phone
(910) 640-0899
Fax
(910) 256-6039
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Micrographic Dermatologic Surgery (MDS)
Also: Dermatology
Education
Emory University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

144 Poole Rd
Suite 101
Leland, NC 28451-9504
Phone (910) 640-0899

Merit-based Incentive Payment System (MIPS)

Final score
98.75 of 100 (individual)
Quality
97.73
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision180
Removal of skin lesions1544
Removal of skin cancer875
Removal or shaving of skin growth1-10
Skin biopsy704

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120629000287 NC Practitioner - Micrographic Dermatologic Surgery (MDS)
Practitioner - Dermatology
3779584222 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
046046GAMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bluewater Dermatology and Skin Cancer Center PA Mohs-Micrographic Surgery Current
since Aug 1, 2017
Accepting new patients
Associates in Dermatology, PLLC Past
since May 1, 2016
Accepting new patients
Dermatology Associates of Georgia, LLC Past
since Jan 1, 1999
Accepting new patients

Locations

144 Poole Rd
#101
Leland, NC 28451
Phone (910) 640-0899

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 046046 GA
MOHS-Micrographic Surgery Physician 207ND0101X 2012-00516 NC Yes

Addresses

Primary practice location

144 Poole Rd Ste 101
Leland, NC 28451-9504

Mailing address

144 Poole Rd Ste 101
Leland, NC 28451-9504
Phone (910) 640-0899

Other identifiers

IdentifierTypeStateIssuer
11182034OtherNCCAQH
000212917AMedicaidGA

Other providers in Leland, NC

All providers in Leland, NC · MOHS-Micrographic Surgery Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.