Individual provider Active NPI

Alexandra Ewa Walczyszyn, MD

  • Internal Medicine Physician
  • Monroe, NC
National Provider Identifier
1134539182
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021-02255 Issued in NC
Practice address
700 W Roosevelt Blvd
Monroe, NC 28110-3437
Phone
(980) 993-7300
NPI assigned
Apr 29, 2014
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 2021-02255 NC
Pediatric Hospice and Palliative Medicine Physician 2080H0002X 2021-02255 NC
Internal Medicine Physician 207R00000X 2021-02255 NC Primary

Addresses

Primary practice location

700 W Roosevelt Blvd
Monroe, NC 28110-3437

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 351-0478

Other practice location 2

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 351-9422

Other practice location 3

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 351-3791

Other practice location 4

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 607-3249

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address awalczyszyn499861@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: 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
I20210817002080 NC Practitioner - Hospice/Palliative Care 8820339591 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021-02255NCMDPediatric Hospice and Palliative Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Aug 1, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

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

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

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

700 W Roosevelt Blvd
Monroe, NC 28110
Phone (704) 292-2100

Interoperability endpoints

  • Direct secure messaging: awalczyszyn85703@direct.medisys.org
  • Direct secure messaging: awalczyszyn499861@carolinashealthcaresystem.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Atrium Health Hospice Union; Atrium Health Hospice AnsonMonroe, NC, CCN 341513 Hospice W-2 Managing Employee Jan 16, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

NPI Registry JSON

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1134539182",
    "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": "700 W ROOSEVELT BLVD",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103437",
            "telephone_number": "980-993-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8800 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623300",
            "country_code": "US",
            "telephone_number": "704-351-0478",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10628 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-351-9422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-351-3791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Vail Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-607-3249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALCZYSZYN",
        "first_name": "ALEXANDRA",
        "middle_name": "EWA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2024-07-15",
        "certification_date": "2022-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2021-02255",
            "primary": false
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "NC",
            "license": "2021-02255",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-02255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "awalczyszyn499861@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "700 W Roosevelt Blvd",
            "city": "Monroe",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281103437",
            "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 Monroe, NC

Sources for this page

Verify at the official NPI Registry.