SOUTHEASTERN REGIONAL PHYSICIAN SERVICES
Medicare Clinicians for NPI 1164028361
Clinic/Center in Lumberton, NC

Active since December 11, 2020
2901 N ELM ST, LUMBERTON, NC 28358(910) 671-5395 Get Directions

NPPES record last updated: December 11, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Clinicians Billing Medicare Through This Organization CMS

Clinicians who reassign their Medicare billing to this organization, per CMS enrollment records.

Southeastern Regional Physician Services in Lumberton, NC bills Medicare for 122 clinicians across 21 Medicare specialties. The largest specialties are Nurse Practitioner with 31, Family Practice with 19 and Cardiovascular Disease (Cardiology) with 17. Of these, 8 practice at this address and 62 within 10 miles. Search by name or filter by specialty; each name links to that clinician's NPI profile.

122Clinicians
21Medicare specialties
122PECOS enrolled
103Accept Medicare
122 clinicians in 21 specialties

Nurse Practitioner (31)

Nurse Practitioner
NPI 1497481824
2934 N ELM ST STE B
Lumberton, NC 28358
(910) 272-1175
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1962127837
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1053947150
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1235680398
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1629363122
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1932198702
2934 N ELM ST STE B1
Lumberton, NC 28358
(910) 272-9675
✔ PECOS0.1 mi
Nurse Practitioner
NPI 1215713581
2934 N ELM ST STE B
Lumberton, NC 28358
(910) 272-1175
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1043096282
2934 N ELM ST STE B
Lumberton, NC 28358
(910) 272-1175
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1912568122
725 OAKRIDGE BLVD STE C1
Lumberton, NC 28358
(910) 738-9414
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1184789026
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1770231912
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1760913974
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1841863560
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1780255026
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Nurse Practitioner
NPI 1972136331
400 LIBERTY HILL RD
Lumberton, NC 28358
(910) 739-3318
✔ PECOS✔ Accepts Medicare1.7 mi
Nurse Practitioner
NPI 1568458495
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1770059941
4901 DAWN DR STE 3100
Lumberton, NC 28360
(910) 671-8556
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1538771795
4901 DAWN DR STE 3300
Lumberton, NC 28360
(910) 671-9298
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1013560697
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1770844995
5070 FAYETTEVILLE RD
Lumberton, NC 28358
(910) 730-0133
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1376904011
5070 FAYETTEVILLE RD
Lumberton, NC 28358
(910) 739-0133
✔ PECOS✔ Accepts Medicare1.8 mi
Nurse Practitioner
NPI 1811965692
101 N WALNUT ST
Fairmont, NC 28340
(910) 628-0655
✔ PECOS✔ Accepts Medicare11 mi
Nurse Practitioner
NPI 1285204388
217 W BROAD ST
Saint Pauls, NC 28384
(910) 241-3078
✔ PECOS✔ Accepts Medicare12 mi
Nurse Practitioner
NPI 1295224525
217 W BROAD ST
Saint Pauls, NC 28384
(910) 241-3078
✔ PECOS✔ Accepts Medicare12 mi
Nurse Practitioner
NPI 1164999843
923 W 3RD ST STE C
Pembroke, NC 28372
(910) 521-0564
✔ PECOS✔ Accepts Medicare12 mi
Nurse Practitioner
NPI 1770650749
923 W 3RD ST
Pembroke, NC 28372
(910) 775-9027
✔ PECOS✔ Accepts Medicare12 mi
Nurse Practitioner
NPI 1174512933
1249 CHICKEN FOOT RD
Hope Mills, NC 28348
(910) 423-1278
✔ PECOS✔ Accepts Medicare21 mi
Nurse Practitioner
NPI 1114612348
3528 HOLBORN DR
Hope Mills, NC 28348
(910) 670-6031
✔ PECOS✔ Accepts Medicare23 mi
Nurse Practitioner
NPI 1952881567
2817 ROCK MERRITT AVE STOP A
Fort Bragg, NC 28310
(910) 908-4673
✔ PECOS30 mi
Nurse Practitioner
NPI 1750908174
600 E PALMETTO ST
Florence, SC 29506
(843) 667-9414
✔ PECOS✔ Accepts Medicare53 mi
Nurse Practitioner
NPI 1962031039
2334 SOUTH 41ST ST
Wilmington, NC 28403
(800) 999-9883
✔ PECOS70 mi

Family Practice (19)

Family Practice
NPI 1518955269
3005 N ELM ST
Lumberton, NC 28358
(910) 738-7789
✔ PECOS✔ Accepts Medicare0.1 mi
Family Practice
NPI 1023017514
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS0.1 mi
Family Practice
NPI 1598290561
730 OAKRIDGE BLVD
Lumberton, NC 28358
(910) 738-2662
✔ PECOS✔ Accepts Medicare1.6 mi
Family Practice
NPI 1982394383
730 OAKRIDGE BLVD
Lumberton, NC 28358
(910) 738-2662
✔ PECOS1.6 mi
Family Practice
NPI 1336671320
730 OAKRIDGE BLVD
Lumberton, NC 28358
(910) 738-2662
✔ PECOS✔ Accepts Medicare1.6 mi
Family Practice
NPI 1639183700
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Family Practice
NPI 1437158201
725 OAKRIDGE BLVD SUITE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Family Practice
NPI 1518962521
725 OAKRIDGE BLVD STE B2
Lumberton, NC 28358
(910) 671-0052
✔ PECOS✔ Accepts Medicare1.6 mi
Family Practice
NPI 1922197136
9858 N WR LATHAM DR
Clarkton, NC 28433
(910) 647-1503
✔ PECOS✔ Accepts Medicare22 mi
Family Practice
NPI 1558334201
103 S OWEN ST
Elizabethtown, NC 28337
(910) 862-2900
✔ PECOS✔ Accepts Medicare23 mi
Family Practice
NPI 1548751720
1601 OWEN DR
Fayetteville, NC 28304
(910) 678-0100
✔ PECOS✔ Accepts Medicare28 mi
Family Practice
NPI 1366051922
1213 CULBRETH DR
Wilmington, NC 28405
(910) 742-1290
✔ PECOS✔ Accepts Medicare73 mi
Family Practice
NPI 1881622801
324 N QUEEN ST
Kinston, NC 28501
(252) 522-9800
✔ PECOS✔ Accepts Medicare92 mi
Family Practice
NPI 1386753325
8401 MEDICAL PLAZA DR STE 300
Charlotte, NC 28262
(704) 316-6561
✔ PECOS✔ Accepts Medicare111 mi
Family Practice
NPI 1891881959
180 PARKWOOD DR
Elkin, NC 28621
(336) 601-1980
✔ PECOS✔ Accepts Medicare152 mi
Family Practice
NPI 1356571459
591 OLD FORT RD
Rocky Mount, VA 24151
(000) 000-0000
✔ PECOS✔ Accepts Medicare169 mi
Family Practice
NPI 1831545383
501 CETRONIA RD STE 135
Allentown, PA 18104
(484) 426-2400
✔ PECOS✔ Accepts Medicare452 mi
Family Practice
NPI 1578981791
295 ROUTE 304
Bardonia, NY 10954
(845) 215-9567
✔ PECOS✔ Accepts Medicare523 mi
Family Practice
NPI 1477286714
520 N 4TH ST
Springfield, IL 62702
(217) 545-8000
✔ PECOS686 mi

Cardiovascular Disease (Cardiology) (17)

Cardiovascular Disease (Cardiology)
NPI 1831435494
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1780895599
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1245235506
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1114969433
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts Medicare0.1 mi
Cardiovascular Disease (Cardiology)
NPI 1053461319
403 W 27TH ST
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts Medicare0.3 mi
Cardiovascular Disease (Cardiology)
NPI 1083611586
725 OAKRIDGE BLVD STE A3
Lumberton, NC 28358
(910) 738-1141
✔ PECOS✔ Accepts Medicare1.6 mi
Cardiovascular Disease (Cardiology)
NPI 1790984458
6322 FAYETTEVILLE RD SUITE B
Raeford, NC 28376
(910) 878-6700
✔ PECOS✔ Accepts Medicare28 mi
Cardiovascular Disease (Cardiology)
NPI 1962460550
3650 CAPE CENTER DR
Fayetteville, NC 28304
(910) 483-0049
✔ PECOS✔ Accepts Medicare28 mi
Cardiovascular Disease (Cardiology)
NPI 1881792570
1550 FAULK ST SUITE 3100
Monroe, NC 28112
(704) 283-1990
✔ PECOS89 mi
Cardiovascular Disease (Cardiology)
NPI 1336190883
2503 N QUEEN ST
Kinston, NC 28501
(252) 523-6000
✔ PECOS✔ Accepts Medicare93 mi
Cardiovascular Disease (Cardiology)
NPI 1023194479
1234 HUFFMAN MILL ROAD
Burlington, NC 27215
(336) 538-2374
✔ PECOS✔ Accepts Medicare102 mi
Cardiovascular Disease (Cardiology)
NPI 1932103660
6060 PIEDMONT ROW DR S FL 10
Charlotte, NC 28287
(704) 489-3094
✔ PECOS✔ Accepts Medicare110 mi
Cardiovascular Disease (Cardiology)
NPI 1346217247
336 DEERFIELD RD
Boone, NC 28607
(828) 262-4100
✔ PECOS✔ Accepts Medicare184 mi
Cardiovascular Disease (Cardiology)
NPI 1407896913
45 HENDERSONVILLE HWY
Pisgah Forest, NC 28768
(828) 435-8080
✔ PECOS✔ Accepts Medicare214 mi
Cardiovascular Disease (Cardiology)
NPI 1902873979
10710 CHARTER DR SUITE 400
Columbia, MD 21044
(410) 997-7979
✔ PECOS337 mi
Cardiovascular Disease (Cardiology)
NPI 1831399542
565 ABBOTT RD
Buffalo, NY 14220
(716) 826-7000
✔ PECOS✔ Accepts Medicare566 mi
Cardiovascular Disease (Cardiology)
NPI 1740485390
4660 S HAGADORN RD STE 600
East Lansing, MI 48823
(517) 267-2460
✔ PECOS✔ Accepts Medicare630 mi

General Surgery (8)

General Surgery
NPI 1629028576
2934 N ELM ST STE E
Lumberton, NC 28358
(910) 739-0022
✔ PECOSSame address
General Surgery
NPI 1285809475
2934 N ELM ST STE E
Lumberton, NC 28358
(910) 739-0022
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1467455493
2934 N ELM ST STE E
Lumberton, NC 28358
(910) 739-0022
✔ PECOS✔ Accepts Medicare0.1 mi
General Surgery
NPI 1629259254
DUKE BREAST CLINIC 2-2
Durham, NC 27710
(919) 681-6604
✔ PECOS✔ Accepts Medicare98 mi
General Surgery
NPI 1417214404
200 MEDICAL PARK DR STE 430
Concord, NC 28025
(704) 403-7070
✔ PECOS✔ Accepts Medicare106 mi
General Surgery
NPI 1861424509
1120 15TH SREET DEPARTMENT OF SURGERY
Augusta, GA 30912
(706) 721-4686
✔ PECOS189 mi
General Surgery
NPI 1245650159
619 19TH ST S
Birmingham, AL 35249
(205) 934-4011
✔ PECOS✔ Accepts Medicare459 mi
General Surgery
NPI 1205835493
485 S DOBSON RD STE 111
Chandler, AZ 85224
(480) 407-4999
✔ PECOS✔ Accepts Medicare1,881 mi

Obstetrics/Gynecology (8)

Obstetrics/Gynecology
NPI 1700089885
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1669600912
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1962586214
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1689664336
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1558334086
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1386638260
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Obstetrics/Gynecology
NPI 1669690210
600 MOYE BLVD
Greenville, NC 27834
(252) 744-2350
✔ PECOS✔ Accepts Medicare113 mi
Obstetrics/Gynecology
NPI 1730119512
1990 INDUSTRIAL BLVD
Houma, LA 70363
(985) 868-9300
✔ PECOS769 mi

Certified Nurse Midwife (CNM) (6)

Certified Nurse Midwife (CNM)
NPI 1083099568
4300 FAYETTEVILLE RD
Lumberton, NC 28358
(910) 608-3078
✔ PECOS✔ Accepts Medicare1.0 mi
Certified Nurse Midwife (CNM)
NPI 1215153168
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Certified Nurse Midwife (CNM)
NPI 1710104708
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Certified Nurse Midwife (CNM)
NPI 1558487744
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi
Certified Nurse Midwife (CNM)
NPI 1598854325
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS1.8 mi
Certified Nurse Midwife (CNM)
NPI 1093945115
1061 MEDICAL CENTER DR
Orange City, FL 32763
(386) 917-5000
✔ PECOS✔ Accepts Medicare416 mi

Internal Medicine (5)

Internal Medicine
NPI 1043217656
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare0.2 mi
Internal Medicine
NPI 1780681015
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare0.2 mi
Internal Medicine
NPI 1174218218
300 W 27TH ST
Lumberton, NC 28358
(910) 671-5000
✔ PECOS✔ Accepts Medicare0.2 mi
Internal Medicine
NPI 1720011570
725 OAKRIDGE BLVD STE C1
Lumberton, NC 28358
(910) 738-9414
✔ PECOS✔ Accepts Medicare1.6 mi
Internal Medicine
NPI 1891364659
1546 PORTER ST
Fort Detrick, MD 21702
(757) 576-6786
✔ PECOS343 mi

Hospitalist (4)

Hospitalist
NPI 1538325642
395 W 27TH ST
Lumberton, NC 28358
(910) 739-7551
✔ PECOS✔ Accepts Medicare0.2 mi
Hospitalist
NPI 1891794384
923 W 3RD ST
Pembroke, NC 28372
(910) 522-8888
✔ PECOS✔ Accepts Medicare12 mi
Hospitalist
NPI 1093946832
200 HAWTHORNE LN
Charlotte, NC 28204
(704) 384-5416
✔ PECOS✔ Accepts Medicare110 mi
Hospitalist
NPI 1033126156
601 W 2ND ST
Bloomington, IN 47403
(812) 353-9515
✔ PECOS✔ Accepts Medicare521 mi

Thoracic Surgery (4)

Thoracic Surgery
NPI 1124108303
300 W 27TH ST
Lumberton, NC 28358
(910) 671-5000
✔ PECOS✔ Accepts Medicare0.2 mi
Thoracic Surgery
NPI 1932283082
3112 CASEY ST
Loris, SC 29569
(843) 716-8940
✔ PECOS✔ Accepts Medicare40 mi
Thoracic Surgery
NPI 1982962734
125 QUEENS RD STE 430
Charlotte, NC 28204
(980) 302-6700
✔ PECOS111 mi
Thoracic Surgery
NPI 1851366892
951 COMMERCE PKWY SUITE 201
Lima, OH 45804
(419) 227-7702
✔ PECOS✔ Accepts Medicare502 mi

Vascular Surgery (4)

Vascular Surgery
NPI 1154564813
DUKE UNIVERSITY MEDICAL CTR BOX 2910
Durham, NC 27710
(919) 668-3426
✔ PECOS✔ Accepts Medicare94 mi
Vascular Surgery
NPI 1225074313
115 HEART DR
Greenville, NC 27834
(252) 744-4400
✔ PECOS113 mi
Vascular Surgery
NPI 1699803940
3636 HIGH ST
Portsmouth, VA 23707
(757) 398-2200
✔ PECOS✔ Accepts Medicare213 mi
Vascular Surgery
NPI 1962571919
1005 HARBORSIDE DRIVE 5TH FLOOR
Galveston, TX 77555
(409) 772-6787
✔ PECOS✔ Accepts Medicare995 mi

Orthopedic Surgery (3)

Orthopedic Surgery
NPI 1194058404
4901 DAWN DR STE 2300
Lumberton, NC 28360
(910) 738-1065
✔ PECOS1.8 mi
Orthopedic Surgery
NPI 1518947290
4901 DAWN DR STE 2300
Lumberton, NC 28360
(910) 738-1065
✔ PECOS✔ Accepts Medicare1.8 mi
Orthopedic Surgery
NPI 1801093695
116 BIBLE CROSSING ROAD
Decherd, TN 37324
(931) 962-2272
✔ PECOS✔ Accepts Medicare404 mi

Pediatric Medicine (3)

Pediatric Medicine
NPI 1952393225
300 W 27TH ST
Lumberton, NC 28358
(910) 671-5000
✔ PECOS0.2 mi
Pediatric Medicine
NPI 1740417906
923 W 3RD ST
Pembroke, NC 28372
(910) 521-0564
✔ PECOS✔ Accepts Medicare12 mi
Pediatric Medicine
NPI 1962575621
101 MANNING DR
Chapel Hill, NC 27599
(919) 966-4996
✔ PECOS87 mi

Cardiac Electrophysiology (2)

Cardiac Electrophysiology
NPI 1023285582
2301 ERWIN RD
Durham, NC 27710
(919) 970-6972
✔ PECOS✔ Accepts Medicare94 mi
Cardiac Electrophysiology
NPI 1104865278
601 ELMWOOD AVE BOX 679B
Rochester, NY 14642
(585) 275-4751
✔ PECOS✔ Accepts Medicare590 mi

Cardiac Surgery (1)

Cardiac Surgery
NPI 1871596726
747 N RUTLEDGE ST FL 4
Springfield, IL 62702
(217) 545-8000
✔ PECOS✔ Accepts Medicare686 mi

Endocrinology (1)

Endocrinology
NPI 1427425669
301 E WENDOVER AVE STE 211
Greensboro, NC 27401
(336) 832-3088
✔ PECOS✔ Accepts Medicare109 mi

Gastroenterology (1)

Gastroenterology
NPI 1225199409
13 MEDICAL CAMPUS DR NW STE 102
Supply, NC 28462
(910) 754-5988
✔ PECOS✔ Accepts Medicare60 mi

Gynecological Oncology (1)

Gynecological Oncology
NPI 1427161579
4901 DAWN DR STE 3200
Lumberton, NC 28360
(910) 735-8040
✔ PECOS✔ Accepts Medicare1.8 mi

Interventional Cardiology (1)

Interventional Cardiology
NPI 1104302082
2936 N ELM ST STE 102
Lumberton, NC 28358
(910) 671-6619
✔ PECOS✔ Accepts Medicare0.1 mi

Pain Management (1)

Pain Management
NPI 1912126244
4901 DAWN DR SUITE 3300
Lumberton, NC 28360
(910) 671-9298
✔ PECOS✔ Accepts Medicare1.8 mi

Rheumatology (1)

Rheumatology
NPI 1033122668
1249 CHICKEN FOOT RD
Hope Mills, NC 28348
(910) 423-1278
✔ PECOS21 mi

Urology (1)

Urology
NPI 1679568067
815 OAKRIDGE BLVD
Lumberton, NC 28358
(910) 738-7166
✔ PECOS✔ Accepts Medicare1.7 mi
No clinicians match the current filters.

About this data

Medicare reassignment. A clinician who works for a hospital, clinic or medical group usually signs a Medicare reassignment (form CMS-855R). It lets the organization bill Medicare for the clinician's services and receive the payment. This page lists the clinicians whose reassignment to Southeastern Regional Physician Services appears in the CMS Revalidation Reassignment List.

Who is included. Clinicians who bill Medicare under their own NPI through this organization. A clinician can reassign to more than one organization, so the same name may also appear under other groups.

✔ PECOS
Enrolled in Medicare through PECOS, CMS's enrollment system, and eligible to order and refer for Medicare patients.
✔ Accepts Medicare
Accepts Medicare assignment, which means taking the Medicare-approved amount as full payment for covered services.
Same address 4.2 mi
Straight-line distance from this NPI's practice location to the clinician's practice address.

Addresses and phone numbers come from each clinician's own NPPES record, so they may point to another office or to the clinician's own practice.

Source: CMS Revalidation Reassignment List, October 2026 release; addresses, phone numbers and Medicare status from NPPES and PECOS. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.