Individual provider Active NPI

Michael Josilevich, M.D.

  • Internal Medicine Physician
  • Jacksonville, NC
National Provider Identifier
1811088552
Registry record updated Jun 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9500962 Issued in NC
Practice address
1701 Country Club Rd
Jacksonville, NC 28546-6005
Phone
(910) 346-5016
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9500962 NC Primary

Addresses

Primary practice location

1701 Country Club Rd
Jacksonville, NC 28546-6005

Mailing address

317 Harvest Dr
Jacksonville, NC 28540-3812
Phone (910) 478-0730

Other identifiers 3

IdentifierTypeStateIssuer
89013R6MedicaidNC
8947511MedicaidNC
47511OtherNCBC/BS

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
I20100928000508 NC Practitioner - Internal Medicine 5294851200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Ambulatory Services IncGroup PAC ID 4587569256, 18 clinicians

Practice addresses (Care Compare)

31 Office Park Dr
Jacksonville, NC 28546-3219
Phone (910) 346-5016

Hospital & facility affiliations

  • Well Care Home Health Home health agency, Wilmington, NC, CCN 347002
  • Centerwell Home Health Home health agency, Pollocksville, NC, CCN 347333
  • 3HC Home health agency, Goldsboro, NC, CCN 347104
  • Onslow Memorial Hospital Hospital, Jacksonville, NC, CCN 340042

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as group
Quality
90.05
Promoting interoperability
100
Improvement activities
40
Cost
75.04

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9500962NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Ambulatory Services, Inc. CurrentSince Oct 1, 2010 Accepting new patients
Onslow Ambulatory Services, Inc. CurrentSince Mar 27, 2022 Accepting new patients
Onslow Ambulatory Services, Inc Internal Medicine CurrentSince Oct 1, 2010 Accepting new patients

Locations

166 Memorial Ct
Jacksonville, NC 28546
Phone (910) 353-9565

215B Station St
Jacksonville, NC 28546
Phone (910) 455-8669

241 New River Dr
Jacksonville, NC 28540
Phone (910) 430-4152

1701 Country Club Rd
Jacksonville, NC 28546
Phone (910) 346-2345

31 Office Park Dr
Jacksonville, NC 28546
Phone (910) 219-1713

Organizations & group practices 3

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 5

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1811088552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 HARVEST DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403812",
            "telephone_number": "910-478-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 COUNTRY CLUB RD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466005",
            "telephone_number": "910-346-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSILEVICH",
        "first_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "9500962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013R6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8947511",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "47511",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.