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MARCUS CRAIG WHALEY MD
NPI 1124011523
Pediatrics in New Bern, NC

Active since August 31, 2005PECOS Enrolled
47.59/100
CMS Quality Rating
2636 DR MARTIN LUTHER KING JR BLVD, NEW BERN, NC 28562(252) 636-1919(252) 636-2656 Get Directions Write a Review

NPPES record last updated: July 30, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 30, 2019, Mar 17, 2017 (2 updates tracked since 2017).

About Marcus Craig Whaley Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARCUS CRAIG WHALEY MD (NPI 1124011523) is an individual pediatrics provider in New Bern, North Carolina, licensed in North Carolina (200300105) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124011523
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMARCUS CRAIG WHALEYCredential: MD
Location Address2636 DR MARTIN LUTHER KING JR BLVDNew Bern, NC 28562-4238
Mailing AddressPo Box 896206Charlotte, NC 28289-6206 · (252) 636-1919 · Fax (252) 636-2656
Phone(252) 636-1919
Fax(252) 636-2656
Sole ProprietorNo
Enumeration DateAugust 31, 2005
Last NPPES UpdateJuly 30, 20192 updates tracked since enumeration
✔ NPI 1124011523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 200300105
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2636 DR MARTIN LUTHER KING JR BLVD, New Bern, NC 28562
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Other Identifiers 3

Other2018380CNC · Medicare Ptan
Medicaid89136MFNC
Other136MFNC · Blue Cross

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Cigna Healthcare, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marcus Craig Whaley Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Marcus Whaley reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carolinaeast Physicians
Same address
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
New Bern, NC 28562
  • Reassigned Medicare billing, North Carolina enrollment
  • 320 clinicians in this Medicare group
NPI 1235430976 (252) 636-1919

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28562 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

47.59/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality43.48
Promoting Interoperability0
Improvement Activities40
Cost65.16

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTI D GORDIN MD
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919
DR. REBECCA C. H. RILEY MD
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919
CAROLINAEAST PHYSICIANS
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919
DR. MICHAEL STANLEY SULLIVAN MD
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919
JENNIFER LOUISE SMITH M.D.
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919
JENNIE CRAIG MANGUN MD
Pediatrics
2636 DR MARTIN LUTHER KING JR BLVD
NEW BERN, NC 28562
Craven County (252) 636-1919

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marcus Whaley's NPI number?

The NPI number for Marcus Whaley is 1124011523. It was assigned to this individual provider in the NPPES registry on August 31, 2005.

Where is Marcus Whaley located?

Marcus Whaley practices at 2636 Dr Martin Luther King Jr Blvd, New Bern, NC 28562. The listed phone number is (252) 636-1919.

What is Marcus Whaley's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Marcus Whaley enrolled in Medicare?

Yes. Marcus Whaley is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Marcus Whaley's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Marcus Whaley reassigns Medicare benefits to Carolinaeast Physicians (New Bern, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Marcus Whaley's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Marcus Whaley accept?

Health plans from Blue Cross and Blue Shield of NC, Cigna Healthcare and UnitedHealthcare list Marcus Whaley as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Marcus Whaley was last updated on July 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.