Individual provider Active NPI

Robert Brian Fazia, MD

  • Cardiovascular Disease Physician
  • Charlotte, NC
National Provider Identifier
1093715039
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
9500897 Issued in NC
Practice address
1718 E 4TH St
Suite 501
Charlotte, NC 28204-3261
Phone
(704) 343-9800
Fax
(704) 347-2011
NPI assigned
Jul 29, 2005
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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 9500897 NC Primary
Interventional Cardiology Physician 207RI0011X 0095-00897 NC

Addresses

Primary practice location

1718 E 4TH St
Suite 501
Charlotte, NC 28204-3261

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
8931433MedicaidNC
N00897MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rfazia34689@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
I20071219000381 NC Practitioner - Cardiovascular Disease (Cardiology) 1658461280 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wake Forest University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

2825 Lyndhurst Ave
Winston Salem, NC 27103-4146

3641 Westgate Ctr Cir
Suite a
Winston Salem, NC 27103-4146
Phone (704) 384-8200

401 Mocksville Ave
FL 2
Salisbury, NC 28144-2735
Phone (704) 633-9620

5145 Sellers Rd
Shallotte, NC 28470-3405

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5099

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0095-00897NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Mint Hill Medical Center, LLC CurrentSince Jul 1, 2019 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2016 Accepting new patients
Novant Medical Group, Inc. CurrentSince Sep 19, 2020 Accepting new patients
Novant Health Matthews Medical Center LLC CurrentSince Mar 1, 2016 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Aug 1, 2007 Accepting new patients
Novant Health Rowan Medical Center, LLC CurrentSince Dec 5, 2014 Accepting new patients
Novant Health Rowan Medical Center LLC CurrentSince Dec 5, 2014 Accepting new patients
Novant Health Medical Group, LLC Cardiovascular Disease CurrentSince Aug 1, 2007 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2016 Accepting new patients
Novant Health Ballantyne Medical Center LLC CurrentSince Sep 6, 2023 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Novant Health Rowan Medical Center LLC Past Accepting new patients

Locations

10905 Providence Rd W
Charlotte, NC 28277
Phone (980) 488-4000

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

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

125 Queens Rd
Ste 200
Charlotte, NC 28204

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

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

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

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

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

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

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

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: rfazia34689@direct.novanthealth.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 1

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": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1093715039",
    "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": "1718 E 4TH ST",
            "address_2": "SUITE 501",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043261",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIA",
        "first_name": "ROBERT",
        "middle_name": "BRIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "9500897",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "0095-00897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8931433",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00897",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rfazia34689@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.