Individual provider Active NPI

Stefan Renaud, D.O.

  • Orthopaedic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1174736599
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
201001601 Issued in NC
Practice address
4601 Park Rd
Ste 300
Charlotte, NC 28209-3239
Phone
(704) 323-2000
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X AB3102516-3183 MI
Orthopaedic Surgery Physician 207X00000X 201001601 NC Primary

Addresses

Primary practice location

4601 Park Rd
Ste 300
Charlotte, NC 28209-3239

Mailing address

706 Summit Crossing PL
Gastonia, NC 28054-2175
Phone (704) 323-2000

Other identifiers 1

IdentifierTypeStateIssuer
NC1229MedicaidSC

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
I20101119000267 NC Practitioner - Orthopedic Surgery 4789737032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of New England, College of Osteo Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

870 Summit Crossing PL
Gastonia, NC 28054-2192
Phone (704) 867-2333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion139
Laminectomy or laminotomy (partial removal of spine bones)53
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AB3102516-3183MIMDOrthopaedic Surgery Physician
201001601NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Orthopaedic Surgery Current Accepting new patients
Orthocarolina Orthopaedic Surgery CurrentSince Oct 1, 2010 Accepting new patients
Orthocarolina, PA Orthopaedic Surgery CurrentSince Oct 1, 2010 Accepting new patients
Orthopedics International LTD. PS Orthopaedic Surgery Past Accepting new patients

Locations

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

870 Summit Crossing Pl
Gastonia, NC 28054
Phone (704) 671-1860

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1174736599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 SUMMIT CROSSING PL",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542175",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "STEFAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "AB3102516-3183",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "201001601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1229",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.