Individual provider Active NPI

Oluseun Olukayode Alli, MD

  • Interventional Cardiology Physician
  • Charlotte, NC
National Provider Identifier
1053524967
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2016-01363 Issued in NC
Practice address
125 Queens Rd Ste 200
Charlotte, NC 28204-3578
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 2016-01363 NC
Interventional Cardiology Physician 207RI0011X 2016-01363 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 200
Charlotte, NC 28204-3578

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 343-9800

Other practice location 1

1718 E 4th St
Suite 501
Charlotte, NC 28204-3261
Phone (704) 343-9800

Other identifiers 2

IdentifierTypeStateIssuer
31807OtherALALABAMA BOARD OF MEDICINE
MT184901OtherPAMED TRAINING NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address oalli321222@direct.novanthealth.org

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
I20160921000761 NC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6002940103 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Baldwin Ave
Suite 200
Charlotte, NC 28204-3370
Phone (704) 384-5043

125 Queens Rd
Charlotte, NC 28204-3215

1401 Matthews Township Pkwy
Suite 110
Matthews, NC 28105-5403
Phone (704) 264-3500

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-9073

9930 Kincey Ave
Suite 200
Huntersville, NC 28078-6541
Phone (704) 887-4530

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting54

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Rowan Medical Center LLC Current Accepting new patients
The Presbyterian Hospital CurrentSince Aug 1, 2016 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Feb 2, 2019 Accepting new patients
Novant Medical Group, Inc. Cardiovascular Disease CurrentSince Aug 1, 2016 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2016 Accepting new patients
The Presbyterian Hospital CurrentSince Aug 1, 2016 Accepting new patients
Novant Medical Group, Inc CurrentSince Mar 11, 2017 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Mar 1, 2016 Accepting new patients
Rowan Regional Medical Center Cardiovascular Disease CurrentSince Feb 2, 2019 Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

2225 Freedom Dr
Charlotte, NC 28208
Phone (704) 316-5166

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

8201 Healthcare Loop
Charlotte, NC 28215
Phone (980) 302-1000

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

125 Queens Rd
Ste 330
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

1718 E 4th St
Ste 501
Charlotte, NC 28204
Phone (704) 868-3256

14035 Grandiflora Dr
Charlotte, NC 28278
Phone (704) 316-1074

125 Queens Rd
Ste 200
Charlotte, NC 28204

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

9930 Kincey Ave
Ste 200
Huntersville, NC 28078
Phone (704) 887-4530

10030 Gilead Rd
Huntersville, NC 28078
Phone (704) 316-4000

1401 Matthews Township Pkwy
Ste 110
Matthews, NC 28105
Phone (704) 264-3500

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

1401 Matthews Township Pkwy
Ste 212312
Matthews, NC 28105
Phone (704) 316-3131

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

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

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

Organizations & group practices 13

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.

View all 13

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": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1053524967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043578",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E 4th St",
            "address_2": "Suite 501",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043261",
            "country_code": "US",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLI",
        "first_name": "OLUSEUN",
        "middle_name": "OLUKAYODE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "2016-01363",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2016-01363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF MEDICINE",
            "identifier": "31807",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED TRAINING NUMBER",
            "identifier": "MT184901",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oalli321222@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "1718 E 4th St",
            "address_2": "Suite 501",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.