Harish Marisiddaiah, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD61064980 Issued in WA

Practice address

2711 X Ray Dr
Gastonia, NC 28054-7491

Phone

(704) 834-2465

Fax

(704) 834-2466

NPI assigned

Sep 29, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Infectious Disease

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Caromont Regional Medical Center Hospital, Gastonia, NC, CCN 340032
• Atrium Health Cleveland Hospital, Shelby, NC, CCN 340021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272

  Infectious Disease

  Medicare reassignment Care Compare group NPD
• Caromont Medical Group Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Gastonia, NC
  • NPI 1184805103
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atrium Health Hospitals Inc

  • General Acute Care Hospital
  • Shelby, NC
  • NPI 1669348991
  Care Compare affiliation
• Gaston Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Gastonia, NC
  • NPI 1013918960
  Care Compare affiliation

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1073500765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544725",
            "telephone_number": "704-671-5311",
            "fax_number": "704-671-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547491",
            "telephone_number": "704-834-2465",
            "fax_number": "704-834-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARISIDDAIAH",
        "first_name": "HARISH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD61064980",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NC",
            "license": "9500993",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8954784",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00993",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Allen Mantooth, M.D.
• Imiah Mapp
• Sierra Margarita
• Marietta Medical Clinic PA
• Marietta Medical Clinic, PA
• Mark E. Taylor, DDS, PA
• Caitlin Mezey Marlow, CNM
• Emily McCotter Marlowe, MA CCC-SLP
• Randall David Marosok, M.D.
• Donna Marquardt, R.N.

• Infectious Disease Physician in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Infectious Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.