Individual provider Active NPI

Ashley Antony

  • Dermatology Physician
  • Raleigh, NC
National Provider Identifier
1780959759
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
2024-00309 Issued in NC
Practice address
7200 Creedmoor Rd Ste 104
Raleigh, NC 27613-1711
Phone
(919) 518-0999
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 2024-00309 NC
Dermatology Physician 207N00000X 2024-00309 NC Primary

Addresses

Primary practice location

7200 Creedmoor Rd Ste 104
Raleigh, NC 27613-1711

Mailing address

1450 Professional Park Dr Ste 150
Winston Salem, NC 27103-1307
Phone (336) 724-2434

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
I20240906000293 NC Practitioner - Dermatology 9931337730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Johns Hopkins University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Surgery Center PAGroup PAC ID 3173599479, 72 clinicians

Practice addresses (Care Compare)

7200 Creedmoor Rd
Suite 104
Raleigh, NC 27613-1711
Phone (919) 518-0999

Merit-based Incentive Payment System (MIPS)

Final score
90.65 of 100Reported as group
Promoting interoperability
89
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision32
Removal of skin lesions291
Removal of skin cancer154
Removal or shaving of skin growth11
Skin biopsy193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024-00309NCMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Skin Surgery Center PA Mohs-Micrographic Surgery CurrentSince Aug 13, 2024 Accepting new patients
Skin Surgery Center PA Dermatology CurrentSince Aug 13, 2024 Accepting new patients

Locations

7200 Creedmoor Rd
Ste 104
Raleigh, NC 27613
Phone (919) 260-0618

1450 Professional Park Dr
Winston Salem, NC 27103
Phone (336) 724-2434

1450 Professional Park Dr
Ste 150
Winston Salem, NC 27103
Phone (336) 724-2434

Organizations & group practices 2

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": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1780959759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 PROFESSIONAL PARK DR STE 150",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031307",
            "telephone_number": "336-724-2434",
            "fax_number": "336-607-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 CREEDMOOR RD STE 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131711",
            "telephone_number": "919-518-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONY",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "2024-00309",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2024-00309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.