MARTIN EUGENE DEBERARDINIS DO
NPI 1801424163
Student in an Organized Health Care Education/Training Program in Winston Salem, NC

Active since March 31, 2020PECOS Enrolled
1 MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157(336) 716-2694 Get Directions Write a Review

NPPES record last updated: March 31, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Martin Eugene Deberardinis Do NPPES

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

MARTIN EUGENE DEBERARDINIS DO (NPI 1801424163) is an individual student in an organized health care education/training program in Winston Salem, North Carolina and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801424163
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMARTIN EUGENE DEBERARDINISCredential: DO
Location Address1 MEDICAL CENTER BOULEVARDWinston Salem, NC 27157-0001
Mailing Address1 Medical Center BoulevardWinston Salem, NC 27157-0001 · (336) 716-2694
Sole ProprietorYes
Enumeration DateMarch 31, 2020
NPPES CertifiedMarch 31, 2020
NPI 1801424163 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1 MEDICAL CENTER BOULEVARD, Winston Salem, NC 27157

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Martin Eugene Deberardinis Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

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.

Speech-Language Pathologist
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Internal Medicine (Cardiovascular Disease)
1 MEDICAL CENTER BOULEVARD, WAKE FOREST BAPTIST MEDICAL CENTER
WINSTON SALEM, NC 27157
Genetic Counselor, MS
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Dietitian, Registered
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Physical Therapist
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157
Student in an Organized Health Care Education/Training Program
1 MEDICAL CENTER BOULEVARD
WINSTON SALEM, NC 27157

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1801424163, enumerated as an "individual" on March 31, 2020.

The provider is located at 1 MEDICAL CENTER BOULEVARD WINSTON SALEM, NC 27157 and the phone number is (336) 716-2694.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.