NPIMap

Individual provider Active NPI

Siddharth P Sura, MD

  • Gastroenterology Physician
  • Charlotte, NC
National Provider Identifier
1184897134
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2014-01092 Issued in NC
Practice address
11430 Red Rust LN Ste 201
Charlotte, NC 28277-4948
Phone
(704) 377-4009
NPI assigned
Apr 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2014-01092 NC Primary

Addresses

Primary practice location

11430 Red Rust LN Ste 201
Charlotte, NC 28277-4948

Mailing address

13808 Professional Center Dr
Huntersville, NC 28078-7948
Phone (704) 717-5549

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
I20140826002673 NC Practitioner - Gastroenterology 0547488926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of North Carolina at Chapel Hill School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15830 Ballantyne Medical PL
Suite 175
Charlotte, NC 28277-0763
Phone (704) 717-5549

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy145
Upper gastrointestinal (GI) endoscopy for acid reflux92

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-01092NCMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince May 17, 2021 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Gastroenterology CurrentSince May 17, 2021 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Past Accepting new patients

Locations

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

15830 Ballantyne Medical Pl
Ste 175
Charlotte, NC 28277
Phone (704) 323-7633

15830 Ballantyne Medical Pl
Ste 150
Charlotte, NC 28277

11430 Red Rust Ln
Ste 201
Charlotte, NC 28277

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

1340 Matthews Township Pkwy
Ste 301
Matthews, NC 28105
Phone (704) 384-8460

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771891200000",
    "number": "1184897134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13808 PROFESSIONAL CENTER DR",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787948",
            "telephone_number": "704-717-5549",
            "fax_number": "704-602-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11430 RED RUST LN STE 201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774948",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURA",
        "first_name": "SIDDHARTH",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-10",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "2014-01092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.