Thomas Joseph Gennosa, MD
Individual provider Active NPI Family Medicine Physician · Robersonville, NC
NPI 1962483446 · NPPES record last updated Oct 19, 2007
Key facts
- NPI
- 1962483446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9900506 (NC)
- Practice address
- 504 N Main St
Robersonville, NC 27871-9567 - Phone
- (252) 795-5555
- Fax
- (252) 795-5566
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- State University of New York at Buffalo School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
504 N Main St
Robersonville, NC 27871-9567
Phone (252) 795-5555
Hospital & facility affiliations
- Gentiva Health Services
- Centerwell Home Health
- Vidant Edgecombe Hospital
- Ecu Health Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
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: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090623000323 | NC | Practitioner - Family Practice | 3577614049 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9900506 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robersonville Physicians PC | Current |
Accepting new patients | |
| Williamston Clinic Corp | Family Medicine | Past |
Accepting new patients |
Locations
504 N Main St
Robersonville, NC 27871
Phone (252) 795-5555
107 W Saint John St
Tarboro, NC 27886
Phone (252) 823-4300
Interoperability endpoints
- gennosa.thomas.004.0330112@roph.meditab.direct-ci.com
- gennosa.thomas.001.0330112@roph.meditab.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9900506 | NC | Yes |
Addresses
Primary practice location
504 N Main St
Robersonville, NC 27871-9567
Mailing address
504 N Main St
Robersonville, NC 27871-9567
Phone (252) 795-5555
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8912294 | Medicaid | NC |
Other providers in Robersonville, NC
- Et-Al Transportation LLC
- Evelyn'S Grace Haven
- First Step Home Care Service Inc
- First Step Home Care Services Inc
- Lisa Gennosa
- Gloria Crandell-Nelson
- Cathy Griffin
- Healthfirst Wellness Center, PLLC
- Suzanne Williams Holland
- Trinea Jones
All providers in Robersonville, NC · Family Medicine Physician 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 Oct 19, 2007. 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.