JOHN W WHELAN M.D.
NPI 1932202116
Internal Medicine in Durham, NC

Active since September 06, 2006PECOS EnrolledAccepts Medicare Assignment
4205 BEN FRANKLIN BLVD, DURHAM, NC 27704(919) 477-6900(919) 477-5081 Get Directions Write a Review

NPPES record last updated: March 18, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About John W Whelan M.d. NPPES

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

JOHN W WHELAN M.D. (NPI 1932202116) is an individual internal medicine provider in Durham, North Carolina, licensed in North Carolina (96-01523) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS, is affiliated with Wakemed, Raleigh Campus, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (1990).

NPPES Registry Identity

NPI1932202116
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameJOHN W WHELANCredential: M.D.
Location Address4205 BEN FRANKLIN BLVDDurham, NC 27704-2143
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (919) 477-6900 · Fax (919) 477-5081
Fax(919) 477-5081
Sole ProprietorNo
Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 1990
Enumeration DateSeptember 6, 2006
Last NPPES UpdateMarch 18, 2015
NPI 1932202116 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in NC · 96-01523
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.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 96-01523 (NC)
4205 BEN FRANKLIN BLVD, Durham, NC 27704

Other Identifiers 6

Medicare UPING31746NC
Medicare PIN2228581BNC
Medicare PIN2228581CNC
Medicare PIN2228581DNC
Medicaid8986740NC
Medicare PIN2228581ENC

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

John W Whelan M.d. 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 ID5597762153
PECOS Enrollment IDI20061025000208
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 13

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.
416 services240 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
247 services247 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
166 services141 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
126 services78 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
59 services56 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
59 services56 patients

Hospital Affiliations CMS Care Compare 2

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

Wakemed, Raleigh Campus

Acute Care Hospitals · Raleigh, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340069
Location3000 New Bern AveRaleigh, NC 27610 · Wake County
Emergency services Birthing friendly

Carteret General Hospital

Acute Care Hospitals · Morehead City, NC
3/5 CMS rating
OwnershipProprietary
CMS Certification Number340142
Location3500 Arendell StMorehead City, NC 28557 · Carteret County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27704 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.

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
9 suppliers29 claims89 services$5.76 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers14 claims14 services$33.02 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers11 claims11 services$75.95 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
5 suppliers15 claims90 services$1.63 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers18 claims18 services$189.41 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Physician Assistant
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Physician Assistant
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704
Internal Medicine
4205 BEN FRANKLIN BLVD
DURHAM, NC 27704

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 John Whelan's NPI number?

The NPI number for John Whelan is 1932202116. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Where is John Whelan located?

John Whelan practices at 4205 Ben Franklin Blvd, Durham, NC 27704. The listed phone number is (919) 477-6900.

What is John Whelan's specialty?

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

Is John Whelan enrolled in Medicare?

Yes. John Whelan 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 John Whelan accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list John Whelan 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 John Whelan affiliated with any hospitals?

According to CMS data, John Whelan is affiliated with Wakemed, Raleigh Campus and Carteret General Hospital.

When was this NPI record last updated?

The NPPES record for John Whelan was last updated on March 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.