JACK XU
NPI 1790239101
Internal Medicine in Winston Salem, NC

Active since August 15, 2016PECOS EnrolledAccepts Medicare Assignment
186 KIMEL PARK DR, WINSTON SALEM, NC 27103(336) 277-2000(336) 277-2050 Get Directions Write a Review

NPPES record last updated: March 22, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 22, 2023, Jul 28, 2022, Feb 18, 2022 and 3 more (6 updates tracked since 2016).

About Jack Xu NPPES

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

JACK XU (NPI 1790239101) is an individual internal medicine provider in Winston Salem, North Carolina, licensed in North Carolina (2022-01767) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with Northern Regional Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1790239101
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJACK XU
Location Address186 KIMEL PARK DRWinston Salem, NC 27103-6946
Mailing AddressPo Box 751803Charlotte, NC 28275-1803 · (336) 277-2000 · Fax (336) 277-2050
Fax(336) 277-2050
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 15, 2016
Last NPPES UpdateMarch 22, 20236 updates tracked since enumeration
NPPES CertifiedOctober 11, 2022
NPI 1790239101 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses Licensed in NC · 2022-01767 Licensed in AR · E-12710
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
186 KIMEL PARK DR, Winston Salem, NC 27103

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Jack Xu is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092049684
PECOS Enrollment IDI20220711001738
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.

Areas of Expertise CMS Part B claims 33

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
257 services161 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
183 services180 patients
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
148 services112 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
85 services84 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
76 services44 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
62 services62 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northern Regional Hospital

Acute Care Hospitals · Mount Airy, NC
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340003
Location830 Rockford StMount Airy, NC 27030 · Surry County
Emergency services Birthing friendly

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340014
Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County
Emergency services Birthing friendly

Randolph Hospital

Acute Care Hospitals · Asheboro, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340123
Location364 White Oak StreetAsheboro, NC 27204 · Randolph County
Emergency services Birthing friendly

Novant Health Medical Park Hospital

Acute Care Hospitals · Winston-Salem, NC
5/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number340148
Location1950 S Hawthorne RdWinston-Salem, NC 27103 · Forsyth County

Ashe Memorial Hospital

Critical Access Hospitals · Jefferson, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number341325
Location200 Hospital AveJefferson, NC 28640 · Ashe County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
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.

Other Providers at the Same Location NPPES 20

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

Nuclear Medicine (Nuclear Cardiology)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Internal Medicine (Cardiovascular Disease)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Physician Assistant
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Nurse Practitioner
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Internal Medicine (Cardiovascular Disease)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Internal Medicine (Cardiovascular Disease)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Internal Medicine (Cardiovascular Disease)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103
Internal Medicine (Interventional Cardiology)
186 KIMEL PARK DR
WINSTON SALEM, NC 27103

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 Jack Xu's NPI number?

The NPI number for Jack Xu is 1790239101. It was assigned to this individual provider in the NPPES registry on August 15, 2016.

Where is Jack Xu located?

Jack Xu practices at 186 Kimel Park Dr, Winston Salem, NC 27103. The listed phone number is (336) 277-2000.

What is Jack Xu's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jack Xu enrolled in Medicare?

Yes. Jack Xu is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jack Xu accept?

Health plans from Blue Cross and Blue Shield of NC list Jack Xu 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.

Is Jack Xu affiliated with any hospitals?

According to CMS data, Jack Xu is affiliated with Northern Regional Hospital, Novant Health Forsyth Medical Center, Randolph Hospital, Novant Health Medical Park Hospital and Ashe Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Jack Xu was last updated on March 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.