CROSS CREEK MEDICAL CLINIC, PA
NPI 1174575179
Internal Medicine in Fayetteville, NC
About Cross Creek Medical Clinic, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CROSS CREEK MEDICAL CLINIC, PA (NPI 1174575179) is a healthcare organization registered as an internal medicine in Fayetteville, North Carolina and active in the NPI registry since May 2006. The organization lists Nitin Dahyabhai Desai, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cross Creek Medical Clinic, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Cross Creek Medical Clinic, PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Cross Creek Medical Clinic, PA's NPI number?
The NPI number for Cross Creek Medical Clinic, PA is 1174575179. It was assigned to this organization in the NPPES registry on May 17, 2006.
Where is Cross Creek Medical Clinic, PA located?
Cross Creek Medical Clinic, PA is located at 1309 Medical Dr Suite 1, Fayetteville, NC 28304. The listed phone number is (910) 437-5130.
What is Cross Creek Medical Clinic, PA's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Cross Creek Medical Clinic, PA enrolled in Medicare?
Yes. Cross Creek Medical Clinic, PA is registered in the Medicare PECOS enrollment system.
When is Cross Creek Medical Clinic, PA's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Cross Creek Medical Clinic, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Cross Creek Medical Clinic, PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Cross Creek Medical Clinic, PA was last updated on December 13, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Cross Creek Medical Clinic, Pa · NPI 1174575179
Internal Medicine organization in Fayetteville, North Carolina. Organization record, active in the CMS NPPES registry since May 17, 2006.
## Identity
- **NPI:** 1174575179 (Entity type: Organization)
- **Enumerated:** May 17, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Nitin Desai, PRESIDENT
## Practice location
- **Address:** 1309 MEDICAL DR, SUITE 1, Fayetteville, NC 28304-4425
- **Phone:** (910) 437-5130 · **Fax:** (910) 437-5130
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, North Carolina, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 13, 2007
- **Other identifiers:** Medicare PIN 2329598 (NC)
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Source: [NPI Profile](https://npiprofile.com/npi/1174575179) · Data from the CMS NPPES public registry.