Individual provider Active NPI

Michael Kreitz Jr., PA-C

  • Medical Physician Assistant
  • High Point, NC
National Provider Identifier
1871593210
Registry record updated Nov 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
100004 Issued in NC
Practice address
905 Phillips Ave
High Point, NC 27262-7075
Phone
(336) 802-2040
Fax
(336) 802-2041
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 100004 NC Primary

Addresses

Primary practice location

905 Phillips Ave
High Point, NC 27262-7075

Mailing address

1701 Westchester Drive
Suite 850
High Point, NC 27265-7254
Phone (336) 802-2400

Other identifiers 1

IdentifierTypeStateIssuer
970015073OtherNCRAILROAD MEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091217000374 NC Practitioner - Physician Assistant 5496895799 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care, PA CurrentSince Jan 1, 1998 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Jan 1, 1998 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients

Locations

1701 Westchester Dr
Ste 850
High Point, NC 27262
Phone (336) 802-2400

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

Organizations & group practices 4

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288569600000",
    "number": "1871593210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DRIVE",
            "address_2": "SUITE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272657254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 PHILLIPS AVE",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627075",
            "telephone_number": "336-802-2040",
            "fax_number": "336-802-2041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITZ",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2010-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "100004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970015073",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.