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DR. ANTHONY RUSSELL IMMEDIATA DMD, PA
NPI 1609809292
Dentist - Oral and Maxillofacial Surgery in Raleigh, NC

Active since July 08, 2006Opted out of Medicare · through Aug 23, 2027
7101 CREEDMOOR RD, SUITE 109, RALEIGH, NC 27613(919) 846-5500 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Anthony Russell Immediata Dmd, Pa NPPES

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

DR. ANTHONY RUSSELL IMMEDIATA DMD, PA (NPI 1609809292) is an individual oral and maxillofacial surgery provider in Raleigh, North Carolina, licensed in North Carolina (5022) and active in the NPI registry since July 2006. He has opted out of Medicare through August 23, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1609809292
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. ANTHONY RUSSELL IMMEDIATACredential: DMD, PA
Location Address7101 CREEDMOOR RD, SUITE 109Raleigh, NC 27613-1682
Mailing Address7101 Creedmoor Rd, Suite 109Raleigh, NC 27613-1682 · (919) 846-5500
Phone(919) 846-5500
Sole ProprietorYes
Enumeration DateJuly 8, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1609809292 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in NC · 5022
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
7101 CREEDMOOR RD, Raleigh, NC 27613
Open in Google Maps ↗

Other Identifiers 3

Medicaid8994426NC
Medicare UPINU08372NC
Medicare ID-Type Unspecified2340076NC

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of NC and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Anthony Russell Immediata Dmd, Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 23, 2017 through August 23, 2027.

Opt-Out Effective DateAugust 23, 2017
Opt-Out In Effect ThroughAugust 23, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27613 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
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

MRS. JANICE C HIRSCH PTA
Physical Therapy Assistant
7101 CREEDMOOR RD
RALEIGH, NC 27613
Wake County (919) 848-3333
SMITA VERMA PT
Physical Therapist (Orthopedic)
7101 CREEDMOOR RD, SUITE 102
RALEIGH, NC 27613
Wake County (919) 848-3333
DR. DICIE DAVINA NATHANI DC
Chiropractor
7101 CREEDMOOR RD, SUITE 102
RALEIGH, NC 27613
Wake County (919) 848-3333
ANTHONY R. IMMEDIATA, D.M.D, P.A.
Dentist (Oral and Maxillofacial Surgery)
7101 CREEDMOOR RD, SUITE 109
RALEIGH, NC 27613
Wake County (919) 846-5500

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 Anthony Immediata's NPI number?

The NPI number for Anthony Immediata is 1609809292. It was assigned to this individual provider in the NPPES registry on July 8, 2006.

Where is Anthony Immediata located?

Anthony Immediata practices at 7101 Creedmoor Rd Suite 109, Raleigh, NC 27613. The listed phone number is (919) 846-5500.

What is Anthony Immediata's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Anthony Immediata enrolled in Medicare?

No. Anthony Immediata has opted out of Medicare through August 23, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Anthony Immediata accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of NC, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 3 other insurers list Anthony Immediata 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 Anthony Immediata was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.