Individual provider Active NPI

Manlio Adam Goetzl, M.D.

  • Urology Physician
  • Pinehurst, NC
National Provider Identifier
1932229853
Registry record updated Sep 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
200900931 Issued in NC
Practice address
5 First Village Drive
Pinehurst Surgical
Pinehurst, NC 28374
Phone
(910) 235-2911
NPI assigned
Apr 2, 2007
Last updated
Sep 6, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 200900931 NC Primary

Addresses

Primary practice location

5 First Village Drive
Pinehurst Surgical
Pinehurst, NC 28374

Mailing address

5 Firstvillage Drive
PO Box 2000
Pinehurst, NC 28374
Phone (910) 295-6831

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
I20090721000271 NC Practitioner - Urology 8729130885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinehurst Surgical Clinic PAGroup PAC ID 4587561394, 92 clinicians

Practice addresses (Care Compare)

5 1St Village Dr
Pinehurst, NC 28374-9495
Phone (910) 295-6831

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200900931NCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc Urology CurrentSince Feb 5, 2015 Accepting new patients
MCPC-9, LLC CurrentSince Mar 24, 2014 Accepting new patients
Pinehurst Surgical Clinic PA Urology CurrentSince Aug 1, 2009 Accepting new patients

Locations

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

5 First Village Dr
Pinehurst, NC 28374
Phone (910) 235-2713

Interoperability endpoints

  • Direct secure messaging: manliogoetzl@psc.allscriptsdirect.net

Organizations & group practices 3

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 4

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1932229853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FIRSTVILLAGE DRIVE",
            "address_2": "PO BOX 2000",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-295-6831",
            "fax_number": "910-295-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FIRST VILLAGE DRIVE",
            "address_2": "PINEHURST SURGICAL",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-235-2911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZL",
        "first_name": "MANLIO",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NC",
            "license": "200900931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.