NPIMap

Individual provider Active NPI

Andrea Luisa Dianderas Pareja, PA

  • Physician Assistant
  • Wadesboro, NC
National Provider Identifier
1083367023
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11702 Issued in NC
Practice address
2301 US Highway 74 W
Wadesboro, NC 28170-7554
Phone
(704) 994-4900
NPI assigned
Jan 31, 2022
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 0010-11702 NC Primary

Addresses

Primary practice location

2301 US Highway 74 W
Wadesboro, NC 28170-7554

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

11530 Providence Rd
Ste 1500
Charlotte, NC 28277-2691
Phone (704) 667-0760

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adianderaspareja728329@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
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220408001119 NC Practitioner - Physician Assistant 2668868100 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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)

101 E W T Harris Blvd
Suite 5401
Charlotte, NC 28262-3485

101 E WT Harris Blvd
Charlotte, NC 28262-3485
Phone (704) 863-9640

14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0010-11702NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Nov 19, 2024 Accepting new patients
Carolinas Physicians Network, Inc CurrentSince Mar 7, 2022 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 7, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 25, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 25, 2023 Accepting new patients
Carolinas Medical Center CurrentSince Mar 7, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients
Carolinas Medical Center Past Accepting new patients

Locations

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

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

101 E Wt Harris Blvd
Ste 2320
Charlotte, NC 28262
Phone (704) 547-0858

11530 Providence Rd
Ste 1500
Charlotte, NC 28277
Phone (704) 667-0760

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

2608 E 7th St
Charlotte, NC 28204
Phone (704) 344-9034

2630 E 7th St
Charlotte, NC 28204
Phone (704) 355-9484

2630 E 7th St
Ste 100
Charlotte, NC 28204
Phone (704) 355-9484

2301 US Highway 74 W
Wadesboro, NC 28170
Phone (704) 694-5131

Interoperability endpoints

  • Direct secure messaging: adianderaspareja728329@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1083367023",
    "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": "2301 US HIGHWAY 74 W",
            "city": "WADESBORO",
            "state": "NC",
            "postal_code": "281707554",
            "telephone_number": "704-994-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11530 Providence Rd",
            "address_2": "Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282772691",
            "country_code": "US",
            "telephone_number": "704-667-0760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIANDERAS PAREJA",
        "first_name": "ANDREA",
        "middle_name": "LUISA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2024-07-15",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adianderaspareja728329@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "2301 US Highway 74 W",
            "city": "Wadesboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281707554",
            "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 Wadesboro, NC

Sources for this page

Verify at the official NPI Registry.