INTRACOASTAL INTERNAL MEDICINE
NPI 1770515272
Internal Medicine in Wilmington, NC
About Intracoastal Internal Medicine NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INTRACOASTAL INTERNAL MEDICINE (NPI 1770515272) is a healthcare organization registered as an internal medicine in Wilmington, North Carolina and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through March 13, 2028 and lists Kimberly Dahlstrom, Admin Asst, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 7
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Intracoastal Internal Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Intracoastal Internal Medicine, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 34D1051890
Intracoastal Internal Medicine PA · Wilmington, NCFrequently 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 Intracoastal Internal Medicine's NPI number?
The NPI number for Intracoastal Internal Medicine is 1770515272. It was assigned to this organization in the NPPES registry on July 7, 2006.
Where is Intracoastal Internal Medicine located?
Intracoastal Internal Medicine is located at 2580 Pickard Rd, Wilmington, NC 28403. The listed phone number is (910) 332-0701.
What is Intracoastal Internal Medicine's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Intracoastal Internal Medicine enrolled in Medicare?
Yes. Intracoastal Internal Medicine is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Intracoastal Internal Medicine?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Intracoastal Internal Medicine. 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. The largest specialties are Nurse Practitioner (5) and Internal Medicine (2). Of these, 4 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Intracoastal Internal Medicine hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 34D1051890) is associated with this NPI, valid through March 13, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Intracoastal Internal Medicine accept?
Health plans from Blue Cross and Blue Shield of NC list Intracoastal Internal Medicine 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 Intracoastal Internal Medicine was last updated on June 19, 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.
# Intracoastal Internal Medicine · NPI 1770515272
Internal Medicine organization in Wilmington, North Carolina. Organization record, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1770515272 (Entity type: Organization)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Kimberly Dahlstrom, ADMIN ASST
## Practice location
- **Address:** 2580 PICKARD RD, Wilmington, NC 28403-4461
- **Phone:** (910) 332-0701 · **Fax:** (910) 332-0710
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Internal Medicine (2); 4 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 19, 2019
- **Other identifiers:** Medicaid 1447204631 (NC); Medicaid 891069V (NC); Medicaid 5903216 (NC); and 4 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1770515272) · Data from the CMS NPPES public registry.