Individual provider Active NPI

Vishalakshi Kalyana Sundaram, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1013162270
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2023-01940 Issued in NC
Practice address
2001 Vail Ave
Ste 400
Charlotte, NC 28207-1248
Phone
(704) 304-7000
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2023-01940 NC Primary

Addresses

Primary practice location

2001 Vail Ave
Ste 400
Charlotte, NC 28207-1248

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 446-9987

Other practice location 2

1106 Reynolds St
Ste 100
Monroe, NC 28112-4375
Phone (704) 289-5443

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vsundaram1217284@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120127000035 NY Practitioner - Family Practice 8527235860 Reassigns benefits to 1 organization
I20230918003315 NC Practitioner - Family Practice 8527235860 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1106 Reynolds St
Suite 100
Monroe, NC 28112-4376
Phone (704) 289-5443

1801 Rozzelles Ferry Rd
Charlotte, NC 28208-4228
Phone (704) 446-9987

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023-01940NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Jul 22, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jul 22, 2023 Accepting new patients
Carolinas Medical Center Current Accepting new patients
Carolinas Medical Center Family Medicine Current Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center Family Medicine CurrentSince Jul 22, 2023 Accepting new patients
Phelps Memorial Hospital Association CurrentSince Jan 2, 2012 Accepting new patients
Phelps Memorial Hospital Association Current Accepting new patients
Phelps Memorial Hospital Association CurrentSince Jan 2, 2012 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince Jul 22, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1801 Rozzelles Ferry Rd
Charlotte, NC 28208
Phone (704) 446-9987

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

2001 Vail Ave
Ste 400
Charlotte, NC 28207
Phone (704) 304-7000

1106 Reynolds St
Ste 100
Monroe, NC 28112
Phone (704) 289-5443

100 S Highland Ave
Ossining, NY 10562
Phone (914) 373-4949

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: vsundaram1217284@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1013162270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 VAIL AVE",
            "address_2": "STE 400",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071248",
            "telephone_number": "704-304-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Rozzelles Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282084228",
            "country_code": "US",
            "telephone_number": "704-446-9987",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 Reynolds St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "NC",
            "postal_code": "281124375",
            "country_code": "US",
            "telephone_number": "704-289-5443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUNDARAM",
        "first_name": "VISHALAKSHI",
        "middle_name": "KALYANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2023-01940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vsundaram1217284@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2001 Vail Ave",
            "address_2": "Ste 400",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282071248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.