Individual provider Active NPI

Laila Noor Menon, M.D.

  • Gastroenterology Physician
  • Mooresville, NC
National Provider Identifier
1023317260
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2021-02017 Issued in NC
Practice address
170 Medical Park Rd
Mooresville, NC 28117-8540
Phone
(704) 664-9506
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 282536 NY
Gastroenterology Physician 207RG0100X 2021-02017 NC Primary

Addresses

Primary practice location

170 Medical Park Rd
Mooresville, NC 28117-8540

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Other identifiers 1

IdentifierTypeStateIssuer
04800208MedicaidNY

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
I20170817000370 NY Practitioner - Gastroenterology 0042582686 Reassigns benefits to 2 organizations
I20210722003280 NC Practitioner - Gastroenterology 0042582686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

170 Medical Park Rd
Mooresville, NC 28117-8540
Phone (704) 664-9506

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy73
Upper gastrointestinal (GI) endoscopy for acid reflux108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282536NYMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Medical Group of the Mount Sinai School of Medicine CurrentSince Nov 1, 2020 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 3, 2017 Accepting new patients
Piedmont Healthcare, PA CurrentSince Sep 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jul 3, 2017 Accepting new patients
North Shore Medical Group of the Mount Sinai School of Medicine Gastroenterology CurrentSince Nov 1, 2020 Accepting new patients
Piedmont Healthcare, P.a. Gastroenterology CurrentSince Sep 1, 2021 Accepting new patients

Locations

170 Medical Park Rd
Mooresville, NC 28117
Phone (704) 660-4649

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

2520 30th Ave
Long Island City, NY 11102
Phone (718) 267-4230

150 E 42nd St
New York, NY 10017
Phone (212) 661-8139

10114 Liberty Ave
#13292
Ozone Park, NY 11417
Phone (718) 487-3330

9901 Queens Blvd
Rego Park, NY 11374
Phone (718) 268-4500

Interoperability endpoints

  • Direct secure messaging: lailamenon@phc.allscriptsdirect.net
  • Direct secure messaging: lmenon3031573@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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 8

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": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1023317260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 MEDICAL PARK RD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178540",
            "telephone_number": "704-664-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "LAILA",
        "middle_name": "NOOR",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "282536",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2021-02017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04800208",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.