Individual provider Active NPI

Massoud Baradaran Shoraka, MD

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
National Provider Identifier
1033616628
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2022-01246 Issued in NC
Practice address
4815 Johnston Oehler Rd
Ste 200
Charlotte, NC 28269-1065
Phone
(704) 801-7410
NPI assigned
Apr 10, 2018
Sex
Male
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
Obstetrics & Gynecology Physician 207V00000X 2022-01246 NC Primary

Addresses

Primary practice location

4815 Johnston Oehler Rd
Ste 200
Charlotte, NC 28269-1065

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1233 The Plz
Charlotte, NC 28207-9008
Phone (704) 446-7800

Other practice location 2

150 Professional Park Dr
Ste 200
Mooresville, NC 28117-5603
Phone (704) 801-7370

Other practice location 3

13620 Reese Blvd E
Ste 100
Huntersville, NC 28078-6417
Phone (704) 801-7330

Other practice location 4

409 Olin Way
Ste 2200
Denver, NC 28037-9243
Phone (704) 801-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221012003251 NC Practitioner - Obstetrics/Gynecology 8123362829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Pittsburgh School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

1020 Tree of Life LN
Cornelius, NC 28031-9454
Phone (704) 801-7330

409 Olin Way
Suite 2200
Denver, NC 28037-9251
Phone (704) 801-7300

447 McAlister Rd
Suite 3500
Lincolnton, NC 28092-4131
Phone (980) 212-6230

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

4815 Johnston Oehler Rd
Charlotte, NC 28269-1065

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health North Market Network LLC Obstetrics & Gynecology CurrentSince Jul 1, 2022 Accepting new patients
Eastover Obstetrics and Gynecology Associates Inc Obstetrics & Gynecology Past Accepting new patients
Eastover Obstetrics and Gynecology Associates Inc Obstetrics & Gynecology Past Accepting new patients

Locations

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

10320 Mallard Creek Rd
Ste 260A
Charlotte, NC 28262
Phone (704) 801-7330

4815 Johnston Oehler Rd
#200
Charlotte, NC 28269
Phone (704) 801-7410

409 Olin Way
Ste 2200
Denver, NC 28037
Phone (704) 801-7300

13620 Reese Blvd E
Ste 100
Huntersville, NC 28078
Phone (704) 801-7330

150 Professional Park Dr
Ste 200
Mooresville, NC 28117
Phone (704) 799-2233

Interoperability endpoints

  • Direct secure messaging: mshoraka916019@carolinashealthcaresystem.direct-ci.com

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 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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1033616628",
    "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": "4815 JOHNSTON OEHLER RD",
            "address_2": "STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282691065",
            "telephone_number": "704-801-7410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 The Plz",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282079008",
            "country_code": "US",
            "telephone_number": "704-446-7800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Professional Park Dr",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281175603",
            "country_code": "US",
            "telephone_number": "704-801-7370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13620 Reese Blvd E",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280786417",
            "country_code": "US",
            "telephone_number": "704-801-7330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "409 Olin Way",
            "address_2": "Ste 2200",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280379243",
            "country_code": "US",
            "telephone_number": "704-801-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORAKA",
        "first_name": "MASSOUD",
        "middle_name": "BARADARAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2024-07-15",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2022-01246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.