NPIMap

Organization Active NPI

Triangle Surgical Associates, P.a.

  • Surgery Physician
  • Fuquay Varina, NC
National Provider Identifier
1700079951
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TRIANGLE SURGICAL ASSOCIATES, P.A.
Practice address
1006 Procure Dr
Suite 200
Fuquay Varina, NC 27526-2627
Phone
(919) 552-1050
Fax
(919) 552-1055
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Victor A Medina, M.D.
Title
President
Phone
(919) 851-5055

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

1006 Procure Dr
Suite 200
Fuquay Varina, NC 27526-2627

Mailing address

115 Crescent Commons Dr
Suite 200
Cary, NC 27518-8102
Phone (919) 851-5055

Other identifiers 3

IdentifierTypeStateIssuer
890199NMedicaidNC
CA2892OtherNCMEDICARE RAILROAD
0199NOtherNCBCBS NC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1700079951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CRESCENT COMMONS DR",
            "address_2": "SUITE 200",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275188102",
            "telephone_number": "919-851-5055",
            "fax_number": "919-851-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 PROCURE DR",
            "address_2": "SUITE 200",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275262627",
            "telephone_number": "919-552-1050",
            "fax_number": "919-552-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIANGLE SURGICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-851-5055",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890199N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA2892",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "0199N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fuquay Varina, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.