Mary Katherine Macaluso, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07458 Issued in NC

Practice address

342 Raleigh St
Holly Springs, NC 27540-9047

Phone

(910) 699-4470

Fax

(919) 238-1146

NPI assigned

Oct 20, 2011

Sex

Female

Sole proprietor

No

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.

• Restoring Balance Psychiatry and Wellness

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  • NPI 1154021046
  NPD Authorized official
• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
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  • NPI 1245223783
  Medicare reassignment NC
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• Geisinger Clinic

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  Medicare reassignment PA
• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Fuquay Varina, NC
  • NPI 1114913092
  NPD
• Advance Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Louisburg, NC
  • NPI 1497918338
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Moosic, PA
  • NPI 1427465848
  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD

Medicare fee-for-service enrollment

Enrolled in PA, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

• Mary Katherine Dullea Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 27, 2023.

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1851676985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HENSLEY OAK WAY",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406185",
            "telephone_number": "910-699-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 RALEIGH ST",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275409047",
            "telephone_number": "910-699-4470",
            "fax_number": "919-238-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACALUSO",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055335",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA055335",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DULLEA",
            "middle_name": "KATHERINE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bradley Lovelace, PHARMD
• Gregg Charles Lowery, DO
• Wendal Lubinsky, LCMHC
• Janice Lustig, OTR/L
• Angela Lynch Fannon, OT
• Laurie Macdonald, LCSW
• Megan Macgregor, MD
• James Machado Workman
• Sowmya Reddy Madduri
• Made to Mother Lactation, PLLC

• All providers in Holly Springs, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.