Dominic Edward Agresta, PA
Individual provider Active NPI Physician Assistant · Salisbury, NC
NPI 1093962045 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1093962045
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-01450 (NC)
- Practice address
- 340 Jake Alexander Blvd W
Ste 105
Salisbury, NC 28147-1364 - Phone
- (704) 403-6240
- NPI assigned
- Aug 21, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carolinas Physicians Network Inc
Practice addresses (Care Compare)
10210 Couloak Dr
Suite E
Charlotte, NC 28216-7695
Phone (704) 801-2000
119 Market Place Ave
Suite D
Mooresville, NC 28117-9157
Phone (704) 801-9140
14214 Ballantyne Lake Rd
Charlotte, NC 28277-3373
1802 E Main St
Lincolnton, NC 28092-3915
Phone (980) 212-2610
Hospital & facility affiliations
- Carolinas Medical Center/Behav Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100927001491 | NC | Practitioner - Physician Assistant | 8729104799 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Bladen Healthcare LLC | Past | Accepting new patients |
Locations
7810 Providence Rd
Ste 102
Charlotte, NC 28226
Phone (704) 393-4808
14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070
10210 Couloak Dr
Ste E
Charlotte, NC 28216
Phone (704) 801-2000
5717 Albemarle Rd
Charlotte, NC 28212
Phone (704) 563-2150
1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791
9332 S Tryon St
Charlotte, NC 28273
Phone (704) 587-6700
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269
Phone (704) 863-9930
340 Jake Alexander Blvd W
Ste 105
Salisbury, NC 28147
Phone (704) 403-6240
Interoperability endpoints
- dagresta412018@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-01450 | NC | Yes |
Addresses
Primary practice location
340 Jake Alexander Blvd W
Ste 105
Salisbury, NC 28147-1364
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
5717 Albemarle Rd
Charlotte, NC 28212-1634
Phone (704) 563-2150
Other practice location 2
7810 Providence Rd
Ste 102
Charlotte, NC 28226-2954
Phone (704) 543-6636
Other practice location 3
5727 Prosperity Crossing Dr
Ste 1100
Charlotte, NC 28269-2206
Phone (704) 863-9930
Other practice location 4
10210 Couloak Dr
Ste E
Charlotte, NC 28216-7679
Phone (704) 801-2000
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dagresta412018@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Salisbury, NC
- Aevum BH NC LLC
- Shelley Louise Africa-Floyd
- Abayomi Aderemi Agbebi
- Matthew Agner
- Tammie G Agner
- Zeeshan Naseer Ahmad
- Bonnie E. Aiken
- Andrea Michelle Aitken
- Olugbenga Francis Akinwuntan
- Shekeia Arnae' Al-Amin
All providers in Salisbury, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.