Individual provider Active NPI

Dorian Joseph Defreitas, MD

  • Vascular Surgery Physician
  • Raleigh, NC
National Provider Identifier
1790984375
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
2012-00656 Issued in NC
Practice address
4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone
(919) 784-2300
NPI assigned
Jul 13, 2007
Last updated
Nov 3, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2012-00565 NC
Surgery Physician 208600000X 2012-00656 NC
Vascular Surgery Physician 2086S0129X 2012-00656 NC Primary

Addresses

Primary practice location

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521

Mailing address

4414 Lake Boone TRL Ste 505
Raleigh, NC 27607-7521
Phone (919) 306-8172

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ddefreitas7079@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
I20120827000130 NC Practitioner - Vascular SurgeryPractitioner - General Surgery 8628225687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians
North Carolina Nephrology PAGroup PAC ID 0244511483, 58 clinicians

Practice addresses (Care Compare)

11200 Governor Manly Way
Suite 303a
Raleigh, NC 27614-7375
Phone (919) 570-7590

3031 New Bern Ave
Suite 200
Raleigh, NC 27610-2989
Phone (919) 747-7820

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)23
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-00565NCMDSpecialist
2012-00656NCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
North Carolina Nephrology PA CurrentSince Oct 1, 2021 Accepting new patients
North Carolina Nephrology PA CurrentSince Oct 1, 2021 Accepting new patients
Rex Hospital Inc Surgery Past Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

5221 Paramount Pkwy
Ste 420
Morrisville, NC 27560
Phone (984) 215-6533

11200 Governor Manly Way
Ste 110
Raleigh, NC 27614
Phone (919) 570-5900

11200 Governor Manly Way
Ste 303A
Raleigh, NC 27614
Phone (919) 570-7590

3031 New Bern Ave
Ste 200
Raleigh, NC 27610
Phone (919) 747-7820

4414 Lake Boone Trl
Ste 505
Raleigh, NC 27607
Phone (984) 974-0500

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

2824 Rogers Rd
Ste 104
Wake Forest, NC 27587

Interoperability endpoints

  • Direct secure messaging: ddefreitas73280@direct.acumenmd.com
  • Direct secure messaging: dorian.defreitas.p123@direct.aac.nextgenshare.com

Organizations & group practices 6

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 1

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1790984375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-306-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 505",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077521",
            "telephone_number": "919-784-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFREITAS",
        "first_name": "DORIAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "2012-00565",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2012-00656",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NC",
            "license": "2012-00656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ddefreitas7079@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "4414 Lake Boone Trl Ste 505",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.