NPIMap

Individual provider Active NPI

Jessica Amelia Tate, MD

  • Neurology Physician
  • Winston Salem, NC
National Provider Identifier
1811159536
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
2012-01535 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-2255
Fax
(336) 716-2801
NPI assigned
Jun 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2012-01535 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2255

Other identifiers 1

IdentifierTypeStateIssuer
5921339MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120913000420 NC Practitioner - Neurology 0345498572 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
West Virginia University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carend Provider Group PAGroup PAC ID 2264827518, 26 clinicians
Carend Provider Group of Kansas PAGroup PAC ID 2961843198, 8 clinicians
Carend Provider Group of New Jersey PCGroup PAC ID 4082082789, 13 clinicians
Care Neurodegenerative Medical of New York PCGroup PAC ID 7618329475, 14 clinicians
Elizabeth Ferluga, M.D., P.CGroup PAC ID 6608246194, 16 clinicians

Practice addresses (Care Compare)

Winston Salem, NC 27106
Phone (708) 630-1534

130 Wing Haven Cir
Winston Salem, NC 27106-6249
Phone (708) 630-1534

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carend Provider Group of Kansas PA Neurology CurrentSince Aug 5, 2025 Accepting new patients
Care Neurodegenerative Medical of New York PC Neurology CurrentSince Jul 5, 2025 Accepting new patients
Carend Provider Group PA Neurology CurrentSince Mar 12, 2025 Accepting new patients
Carend Provider Group of New Jersey PC Neurology CurrentSince Jun 24, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Sep 1, 2012 Accepting new patients
Elizabeth Ferluga, M.D., P.C. Neurology CurrentSince Sep 8, 2025 Accepting new patients

Locations

2045 W Grand Ave
Ste B
Chicago, IL 60612
Phone (800) 827-7437

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

101 Eisenhower Pkwy
Ste 300
Roseland, NJ 07068
Phone (201) 520-7221

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 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": "1214352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1811159536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "JESSICA",
        "middle_name": "AMELIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-25",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2012-01535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5921339",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.