Individual provider Active NPI

Cathrine Constantacos, M.D., F.A.A.P

  • Pediatric Endocrinology Physician
  • Winston Salem, NC
National Provider Identifier
1841433596
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
155205 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 713-4500
Fax
(336) 716-7100
NPI assigned
Apr 10, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M7123 TX
Pediatric Endocrinology Physician 2080P0205X 155205 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 713-4500

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
I20111026000836 NC Practitioner - EndocrinologyPractitioner - Pediatric Medicine 8628241239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

3903 N Elm St
Greensboro, NC 27455-2594
Phone (336) 713-4944

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M7123TXMDPediatrics Physician
155205NCMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 15, 2011 Accepting new patients

Locations

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

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1239321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1841433596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-713-4500",
            "fax_number": "336-716-7100"
        },
        {
            "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": "336-713-4500",
            "fax_number": "336-716-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANTACOS",
        "first_name": "CATHRINE",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.A.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-10",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M7123",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NC",
            "license": "155205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.