Active NPI
Kameliya Hristova, PAC
- Physician Assistant
- Kernersville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1710 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7156 - Phone
- (336) 515-7440
- NPI assigned
- Oct 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1710 Kernersville Medical Pkwy Ste 201
Kernersville, NC 27284-7156
Mailing address
PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 718-1680
Other practice location 1
3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-1680
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | khristova287667@direct.novanthealth.org |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
131 Miller St
Winston Salem, NC 27103-2508
Phone (336) 716-2734
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
- North Carolina Baptist Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
3333 Silas Creek Pkwy
Winston Salem, NC 27103
Phone (336) 277-8800
131 Miller St
Winston Salem, NC 27103
Phone (336) 716-4161
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- khristova2755586@carolinashealthcaresystem.direct-ci.com
- khristova287667@direct.novanthealth.org
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1962872010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751803",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751803",
"telephone_number": "336-718-1680",
"fax_number": "336-718-1681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1710 KERNERSVILLE MEDICAL PKWY STE 201",
"city": "KERNERSVILLE",
"state": "NC",
"postal_code": "272847156",
"telephone_number": "336-515-7440"
}
],
"practiceLocations": [
{
"address_1": "3333 Silas Creek Pkwy",
"address_purpose": "LOCATION",
"city": "Winston Salem",
"state": "NC",
"postal_code": "271033013",
"country_code": "US",
"telephone_number": "336-718-1680",
"fax_number": "336-718-1681",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HRISTOVA",
"first_name": "KAMELIYA",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-01",
"last_updated": "2020-09-24",
"certification_date": "2020-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "khristova287667@direct.novanthealth.org",
"affiliation": "N",
"address_1": "3333 Silas Creek Pkwy",
"city": "Winston Salem",
"state": "NC",
"country_code": "US",
"postal_code": "271033013",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kernersville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.