Individual provider Active NPI

Smitha Reddy Pasula, M.D.

  • Internal Medicine Physician
  • Mooresville, NC
National Provider Identifier
1063707354
Registry record updated Apr 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
201101319 Issued in NC
Practice address
930 W Wilson Ave
Mooresville, NC 28117-8811
Phone
(704) 663-7500
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 201101319 NC Primary

Addresses

Primary practice location

930 W Wilson Ave
Mooresville, NC 28117-8811

Mailing address

104 Prospect Ave
Bayonne, NJ 07002-4542
Phone (201) 658-2864

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
I20110919000767 NC Practitioner - Internal Medicine 9335310598 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimed HospitalistsGroup PAC ID 8022204171, 47 clinicians

Practice addresses (Care Compare)

557 Brookdale Dr
Statesville, NC 28677-4107
Phone (704) 873-5661

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201101319NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimed Hospitalists CurrentSince Feb 18, 2024 Accepting new patients
Trinity Health Care PA Internal Medicine CurrentSince Sep 1, 2011 Accepting new patients
Optimed Hospitalists Internal Medicine CurrentSince Sep 27, 2013 Accepting new patients

Locations

930 W Wilson Ave
Mooresville, NC 28117
Phone (704) 402-3941

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Interoperability endpoints

  • Direct secure messaging: smitha.pasula@opmd.eclinicaldirectplus.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": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1063707354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PROSPECT AVE",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024542",
            "telephone_number": "201-658-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 W WILSON AVE",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178811",
            "telephone_number": "704-663-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASULA",
        "first_name": "SMITHA",
        "middle_name": "REDDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "201101319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.