Dominick John Carbone Jr., MD
Individual provider Active NPI Urology Physician · Elkin, NC
NPI 1790767382 · NPPES record last updated Nov 3, 2011
Key facts
- NPI
- 1790767382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Urology Physician 208800000X
- License
- 9700498 (NC)
- Practice address
- 200 Johnson Ridge Medical Park
Elkin, NC 28621-2443 - Phone
- (336) 526-0040
- Fax
- (336) 526-0043
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Urology
- Education
- University of Michigan Medical School, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Piedmont Stone Center PLLC
Iredell Physician Network LLC
Practice addresses (Care Compare)
1907 S Hawthorne Rd
Winston Salem, NC 27103-3916
Phone (336) 765-6373
542 Brookdale Dr
Statesville, NC 28677-4108
Phone (704) 380-6940
557 Brookdale Dr
Statesville, NC 28677-4107
Phone (336) 765-6373
Hospital & facility affiliations
- Iredell Home Health
- Iredell Memorial Hospital Inc
- Novant Health Forsyth Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Prostate resection | 18 |
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061027000389 | NC | Practitioner - Urology | 9335146778 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9700498 | NC | MD | Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Piedmont Stone Center PLLC | Urology | Current |
Accepting new patients |
| Iredell Physician Network LLC | Current |
Accepting new patients | |
| Iredell Physician Network, LLC | Current |
Accepting new patients | |
| Iredell Physician Network LLC | Current | Accepting new patients | |
| Iredell Physician Network LLC | Past | Accepting new patients | |
| Wake Forest University Health Sciences | Past | Accepting new patients |
Locations
180 Parkwood Dr
Elkin, NC 28621
Phone (336) 527-7000
542 Brookdale Dr
Statesville, NC 28677
Phone (704) 380-6940
766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
1907 S Hawthorne Rd
Winston Salem, NC 27103
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- dominich.carbone@iredell.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 9700498 | NC | Yes |
Addresses
Primary practice location
200 Johnson Ridge Medical Park
Elkin, NC 28621-2443
Mailing address
200 Johnson Ridge Medical Park
Elkin, NC 28621-2443
Phone (336) 526-0040
Other providers in Elkin, NC
- Evan Buck
- Brad Alen Bushong
- Beverly A Byrd
- Robert Coulter Campbell
- Tony Wayne Canupp
- Carenet, Inc.
- Carenet, Inc.
- Carenet, Inc.
- Carenet, Inc.
- Carolina Residential Services, Inc.
All providers in Elkin, NC · Urology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.