Individual provider Active NPI

Thomas Frank Condiano, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1063154292
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9115933 Issued in FL
Practice address
135 W 10TH St
Charlotte, NC 28202-2229
Phone
(704) 626-3994
NPI assigned
Apr 8, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9115933 FL Primary

Addresses

Primary practice location

135 W 10TH St
Charlotte, NC 28202-2229

Mailing address

135 W 10TH St
Charlotte, NC 28202-2229
Phone (704) 626-3994

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620001481 NC Practitioner - Physician Assistant 1355715038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cabarrus Gastroenterology Associates PLLCGroup PAC ID 9436059649, 51 clinicians

Practice addresses (Care Compare)

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

Hospital & facility affiliations

  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Feb 2, 2026 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Feb 2, 2026 Accepting new patients

Locations

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

9965 Poplar Tent Rd
Concord, NC 28027
Phone (704) 783-1840

510 Corporate Cir
#1000
Salisbury, NC 28147
Phone (704) 783-1840

Interoperability endpoints

  • Direct secure messaging: thomas.condiano.1@13989.direct.athenahealth.com

Organizations & group practices 3

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 2

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": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1063154292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 W 10TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022229",
            "telephone_number": "704-626-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W 10TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022229",
            "telephone_number": "704-626-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDIANO",
        "first_name": "THOMAS",
        "middle_name": "FRANK",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.