Sandra G Wilusz, FNP-BC – Nurse Practitioner

Key facts

NPI: 1871739367
Entity type: Individual (NPI type 1)
Primary specialty: Nurse Practitioner 363L00000X
License: 5004260 (NC)
Practice address: 517 Main Ave W
Hildebran, NC 28637-8312
Phone: (828) 580-5561
Fax: (828) 580-3226
NPI assigned: Jan 5, 2009
Sex: Female
Sole proprietor: No

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.

Impact Healthcare, P.a. Family Medicine Physician · Louisburg, NC · NPI 1124537246

Medicare reassignment Care Compare group NPD NC

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Carteret County General Hospital Corporation General Acute Care Hospital · Morehead City, NC · NPI 1760479331

Care Compare affiliation Hospital
Onslow Memorial Hospital Inc General Acute Care Hospital · Jacksonville, NC · NPI 1679535496

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2008
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Impact Healthcare, P.a. (11 clinicians)

Practice addresses (Care Compare)

1057 D Cedar Point Blvd
Cedar Point, NC 28584-8020
Phone (919) 496-4976

Hospital & facility affiliations

Carteret General Hospital Hospital · Morehead City, NC · CCN 340142
Onslow Memorial Hospital Hospital · Jacksonville, NC · CCN 340042

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20090212000677	NC	Practitioner - Nurse Practitioner	6002971736	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Impact Healthcare, P.a.		Current since Nov 8, 2023	Accepting new patients

Locations

1057 Cedar Point Blvd
#D
Cedar Point, NC 28584
Phone (252) 764-2121

1057D Cedar Point Blvd
Cedar Point, NC 28584
Phone (252) 764-2121

315 S Bickett Blvd
Louisburg, NC 27549
Phone (919) 496-4976

Interoperability endpoints

Direct secure messaging: sandra.wilusz.1@23963.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Nurse Practitioner	363L00000X	5004260	NC	Yes

Addresses

Primary practice location

517 Main Ave W
Hildebran, NC 28637-8312

Mailing address

517 Main Ave W
Hildebran, NC 28637-8312
Phone (828) 580-5561

Other identifiers

Identifier	Type	State	Issuer
1871739367	Medicaid	NC

Other providers in Hildebran, NC

All providers in Hildebran, NC · Nurse Practitioner in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.