NPIMap

Organization Active NPI

Carolina Breast Care Specialists, PA

  • Surgery Physician
  • Raleigh, NC
National Provider Identifier
1750337119
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CAROLINA BREAST CARE SPECIALISTS, PA
Practice address
4414 Lake Boone TRL
Suite 211
Raleigh, NC 27607-7513
Phone
(919) 741-5966
Fax
(919) 571-4330
NPI assigned
May 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sean Thomas Canale, MDNPI 1063499796
Title
President
Phone
(919) 741-5966

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NC Primary

Addresses

Primary practice location

4414 Lake Boone TRL
Suite 211
Raleigh, NC 27607-7513

Mailing address

PO Box 16814
Chapel Hill, NC 27516-6814
Phone (919) 967-6646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060606000310 NC Part B Supplier - Clinic/Group Practice 0446261523 Receives reassigned benefits from 1 practitioner
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

4414 Lake Boone Trl
Ste 211
Raleigh, NC 27607
Phone (919) 741-5966

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9247/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750337119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16814",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275166814",
            "telephone_number": "919-967-6646",
            "fax_number": "919-967-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL",
            "address_2": "SUITE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077513",
            "telephone_number": "919-741-5966",
            "fax_number": "919-571-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA BREAST CARE SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANALE",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-741-5966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.