Individual provider Active NPI

Achilles Fakiris, M.D.

  • Radiation Oncology Physician
  • Raleigh, NC
National Provider Identifier
1750336590
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2011-01533 Issued in NC
Practice address
4420 Lake Boone TRL Ste 102
Raleigh, NC 27607-7505
Phone
(919) 784-3018
NPI assigned
May 23, 2006
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 01061773 IN
Radiation Oncology Physician 2085R0001X 2011-01533 NC Primary

Addresses

Primary practice location

4420 Lake Boone TRL Ste 102
Raleigh, NC 27607-7505

Mailing address

4420 Lake Boone TRL Ste 102
Raleigh, NC 27607-7505
Phone (919) 784-3018

Other practice location 1

535 Barnhill Dr
Indianapolis, IN 46202-5112
Phone (317) 944-8660

Other identifiers 1

IdentifierTypeStateIssuer
200827070MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address afakiris11628@direct.UNC.nchie.net Direct

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
I20111214000001 NC Practitioner - Radiation Oncology 5496752792 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Miami, LM Miller School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnston Radiation Oncology LLCGroup PAC ID 7012048838, 19 clinicians
Smithfield Radiation Oncology LLCGroup PAC ID 6709835846, 18 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220

117 Sunnybrook Rd
Raleigh, NC 27610-1827
Phone (919) 334-3900

2076 Veterans Pkwy
Suite 120
Clayton, NC 27520-8343
Phone (919) 585-8550

2801 Blue Ridge Rd
Raleigh, NC 27607-0114
Phone (984) 974-0500

4420 Lake Boone TRL
Raleigh, NC 27607-7505
Phone (919) 784-3100

514 N Brightleaf Blvd
Suite 1200
Smithfield, NC 27577-4486
Phone (919) 209-3555

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-01533NCMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rex Hospital Inc Current Accepting new patients
Smithfield Radiation Oncology, LLC Radiation Oncology CurrentSince Jul 12, 2012 Accepting new patients
Johnston Radiation Oncology LLC Radiation Oncology CurrentSince Jul 1, 2012 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Nov 12, 2011 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Nov 12, 2011 Accepting new patients
Rex Hospital Inc Radiation Oncology PastSince Oct 1, 2019 Accepting new patients
Park Ophthalmology Past Accepting new patients
University Radiation Oncology Associates, Inc. Radiation Oncology Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2076 Veterans Pkwy
Ste 120
Clayton, NC 27520
Phone (919) 585-8550

117 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 334-3900

2901 Blue Ridge Rd
Raleigh, NC 27607
Phone (919) 784-3105

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

4420 Lake Boone Trl
#200
Raleigh, NC 27607
Phone (919) 784-6818

4420 Lake Boone Trl
Ste 102
Raleigh, NC 27607
Phone (919) 784-1473

514 N Brightleaf Blvd
Ste 120
Smithfield, NC 27577

514 N Brightleaf Blvd
Ste 1200
Smithfield, NC 27577
Phone (919) 209-3555

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1750336590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 LAKE BOONE TRL STE 102",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077505",
            "telephone_number": "919-784-3018"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Barnhill Dr",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025112",
            "country_code": "US",
            "telephone_number": "317-944-8660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAKIRIS",
        "first_name": "ACHILLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "IN",
            "license": "01061773",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NC",
            "license": "2011-01533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200827070",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "afakiris11628@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4420 Lake Boone Trl Ste 102",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.