BRUNSWICK SURGICAL ASSOCIATES, PLLC — NPI 1144206822 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery

CMS-1500 Box 24J / 33a • NPI

1144206822

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2086S0129X (CMS 02)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery

Box 32 Service Location & ZIP+4

6 DOCTORS CIR, SUITE 1, SUPPLY, NC, 28462-4089

✓ 9-Digit EDI 837 ZIP+4 (28462-4089)

Practice Phone & Referral Fax

(910) 575-4606

Fax: (910) 575-4609

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1144206822 (BRUNSWICK SURGICAL ASSOCIATES, PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1144206822` (NPI-2 Organization / Facility)
Provider / Legal Name	BRUNSWICK SURGICAL ASSOCIATES, PLLC
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery NUCC Code: `2086S0129X` (N/A)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	6 DOCTORS CIR, SUITE 1, SUPPLY, NC, 28462-4089
Practice Telephone / Fax	Tel: (910) 575-4606 \| Fax: (910) 575-4609
Administrative Mailing Address	6 DOCTORS CIR, SUPPLY, NC, 28462-4089
Enumeration & Last Sync	Enumerated: 2005-12-15 \| CMS Record Updated: 2020-08-22
Authorized Official	MARK TILLOTSON (PARTNER)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

6 DOCTORS CIR, SUITE 1, SUPPLY, NC, 28462-4089

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Plain-English Taxonomy & CMS Crosswalk (2086S0129X)

What Does Taxonomy Code 2086S0129X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2086S0129X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 02 (Physician/General Surgery) • CMS Code 76 (Physician/Peripheral Vascular Disease) • CMS Code 77 (Physician/Vascular Surgery)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (BRUNSWICK SURGICAL ASSOCIATES, PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2086S0129X` — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery	State: NC \| License: `103114` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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BRUNSWICK SURGICAL ASSOCIATES, PLLC (NPI #1144206822)