Individual provider Active NPI

Matthew David Hannibal, MD

  • Orthopaedic Surgery Physician
  • Durham, NC
National Provider Identifier
1811059470
Registry record updated Sep 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2008-00400 Issued in NC
Practice address
120 William Penn PLZ
Durham, NC 27704
Phone
(919) 220-5255
Fax
(919) 313-1276
NPI assigned
Dec 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2008-00400 NC Primary

Addresses

Primary practice location

120 William Penn PLZ
Durham, NC 27704

Mailing address

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

Other practice location 1

232 Sharon Ave NW
Lenoir, NC 28645-4326
Phone (828) 758-7091

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
I20080620000094 NC Practitioner - Orthopedic Surgery 5698871804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emergeortho PAGroup PAC ID 0749188894, 726 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

120 William Penn PLZ
Durham, NC 27704-2150
Phone (919) 220-5255

1501 N Bickett Blvd
Louisburg, NC 27549-2178
Phone (919) 497-8414

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

Hospital & facility affiliations

  • North Carolina Specialty Hospital Hospital, Durham, NC, CCN 340049
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

Merit-based Incentive Payment System (MIPS)

Final score
89.07 of 100Reported as group
Quality
85.94
Promoting interoperability
100
Improvement activities
40
Cost
77.63

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion47
Laminectomy or laminotomy (partial removal of spine bones)27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008-00400NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergeortho PA CurrentSince Jul 12, 2016 Accepting new patients
Emergeortho PA Orthopaedic Surgery CurrentSince Jul 12, 2016 Accepting new patients

Locations

910 W Williams St
Apex, NC 27502
Phone (919) 363-1957

120 William Penn Plz
Durham, NC 27704
Phone (919) 281-1836

2165 Medical Park Dr
Hickory, NC 28602
Phone (828) 294-7793

232 Sharon Ave NW
Lenoir, NC 28645
Phone (828) 459-6824

3100 Duraleigh Rd
Ste 100
Raleigh, NC 27612
Phone (919) 571-6465

799 Doctors Ct
Roxboro, NC 27573
Phone (336) 599-4079

Interoperability endpoints

  • Direct secure messaging: matthew.hannibal.2@847.direct.athenahealth.com

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.

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567728000000",
    "number": "1811059470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042150",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WILLIAM PENN PLZ",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27704",
            "telephone_number": "919-220-5255",
            "fax_number": "919-313-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 Sharon Ave NW",
            "address_purpose": "LOCATION",
            "city": "Lenoir",
            "state": "NC",
            "postal_code": "286454326",
            "country_code": "US",
            "telephone_number": "828-758-7091",
            "fax_number": "828-758-7058",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNIBAL",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2008-00400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.