NPIMap

Individual provider Active NPI

Pulak Dilipkumar Patel

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1023377918
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2015-01299 Issued in NC
Practice address
10650 Park Rd
Suite 420
Charlotte, NC 28210-8538
Phone
(704) 302-8700
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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 2015-01299 NC Primary

Addresses

Primary practice location

10650 Park Rd
Suite 420
Charlotte, NC 28210-8538

Mailing address

10650 Park Rd
Suite 420
Charlotte, NC 28210-8538

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ppatel713432@direct.novanthealth.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151012001996 NC Practitioner - Family Practice 9830408970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Emory University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

2400 S Blvd
Suite 103
Charlotte, NC 28203-5773
Phone (704) 316-3017

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2015-01299NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Apr 7, 2019 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 7, 2019 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

2400 South Blvd
Ste 103
Charlotte, NC 28203
Phone (704) 316-3000

10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Networks

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

Organizations & group practices 4

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

Hospital & facility affiliations 4

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": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1023377918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "SUITE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 PARK RD",
            "address_2": "SUITE 420",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108538",
            "telephone_number": "704-302-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PULAK",
        "middle_name": "DILIPKUMAR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2015-01299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ppatel713432@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "10650 Park Rd",
            "address_2": "Suite 420",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.