Individual provider Active NPI

Richard Justin Boruta, MD

  • Pediatric Cardiology Physician
  • Charlotte, NC
National Provider Identifier
1043444722
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
2015-00923 Issued in NC
Practice address
1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866
Phone
(704) 373-1813
NPI assigned
May 8, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 2015-00923 NC Primary

Addresses

Primary practice location

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203-5866

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

9625 Northcross Center Ct
Ste 102
Huntersville, NC 28078-7348
Phone (704) 403-2860

Other practice location 2

1781 Tate Blvd SE
Ste 203
Hickory, NC 28602-4251
Phone (704) 381-3970

Other practice location 3

100 Medical Park Dr
Ste 310
Concord, NC 28025-2948
Phone (704) 403-2860

Other practice location 4

1656 Riverchase Blvd
Suite 2500
Rock Hill, SC 29732-2084
Phone (803) 327-3456

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rboruta1087374@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 NC, SC2 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
I20151109000148 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 7517101223 Reassigns benefits to 3 organizations
I20230103000313 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 7517101223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Duke University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, shared by 56 NPIs, 2,324 clinicians

Practice addresses (Care Compare)

1001 Blythe Blvd
Suite 500
Charlotte, NC 28203-5863
Phone (704) 373-1813

1656 Riverchase Blvd
Suite 2500
Rock Hill, SC 29732-0269
Phone (803) 327-3456

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jan 3, 2023 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Mar 11, 2019 Accepting new patients
Wakemed CurrentSince Oct 28, 2015 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 3, 2023 Accepting new patients
Wakemed CurrentSince Oct 28, 2015 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Mar 11, 2019 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Pediatric Cardiology CurrentSince Jan 3, 2023 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

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

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

1001 Blythe Blvd
Ste 500
Charlotte, NC 28203
Phone (704) 355-5100

11530 Providence Rd
Charlotte, NC 28277
Phone (704) 373-1813

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

100 Medical Park Dr
Ste 310
Concord, NC 28025
Phone (704) 403-2860

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1781 Tate Blvd SE
Ste 203
Hickory, NC 28602
Phone (704) 381-3970

9625 Northcross Center Ct
Ste 102
Huntersville, NC 28078
Phone (704) 403-2860

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

704 Gold Hill Rd
Ste 203
Fort Mill, SC 29715
Phone (803) 835-0405

1656 Riverchase Blvd
Ste 2500
Rock Hill, SC 29732
Phone (803) 327-3456

Interoperability endpoints

  • Direct secure messaging: rboruta1087374@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1043444722",
    "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": "1001 BLYTHE BLVD",
            "address_2": "STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035866",
            "telephone_number": "704-373-1813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9625 Northcross Center Ct",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787348",
            "country_code": "US",
            "telephone_number": "704-403-2860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1781 Tate Blvd SE",
            "address_2": "Ste 203",
            "address_purpose": "LOCATION",
            "city": "Hickory",
            "state": "NC",
            "postal_code": "286024251",
            "country_code": "US",
            "telephone_number": "704-381-3970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Park Dr",
            "address_2": "Ste 310",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252948",
            "country_code": "US",
            "telephone_number": "704-403-2860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1656 Riverchase Blvd",
            "address_2": "Suite 2500",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297322084",
            "country_code": "US",
            "telephone_number": "803-327-3456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BORUTA",
        "first_name": "RICHARD",
        "middle_name": "JUSTIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2024-08-05",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NC",
            "license": "2015-00923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rboruta1087374@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1001 Blythe Blvd",
            "address_2": "Ste 500",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282035866",
            "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.