JAY ANTHONY REQUARTH MD NPI 1033147657

NPI Information

NPI: 1033147657
Provider Name: JAY ANTHONY REQUARTH, MD
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

PECOS Registration: Yes

Address:
MEDICAL CENTER BLVD
WINSTON SALEM, NC
ZIP 27157
Phone: (336) 716-2255
Get Directions

Jay Anthony Requarth, MD is a vascular and interventional radiology radiology in Winston Salem, NC. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. Jay Anthony Requarth, MD NPI is 1033147657. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

MEDICAL CENTER BLVD
WINSTON SALEM, NC
ZIP 27157-001
Phone: (336) 716-2255

The NPI 1033147657 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 1/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0204X	Radiology	Vascular & Interventional Radiology	2005-00403	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	808939	OTHER		PARTNERS
2	F85920	MEDICARE UPIN
3	86138000	MEDICAID	WEST VIRGINIA
4	142J0	OTHER		BCBS
5	189351	OTHER		MEDCOST
6	4556618	OTHER		AETNA
7	P00367352	MEDICARE PIN	NORTH CAROLINA
8	10411491	MEDICAID	VIRGINIA
9	2059952	MEDICARE PIN	NORTH CAROLINA
10	5904790	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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