Individual provider Active NPI

Mohammad Khalil Kasaji, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1194987677
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2018-02583 Issued in NC
Practice address
5820 E WT Harris Blvd Ste B
Charlotte, NC 28215-3542
Phone
(704) 548-7962
Fax
(704) 631-3431
NPI assigned
Jun 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 271425 NY
Family Medicine Physician 207Q00000X 2018-02583 NC Primary

Addresses

Primary practice location

5820 E WT Harris Blvd Ste B
Charlotte, NC 28215-3542

Mailing address

PO Box 601843
Charlotte, NC 28260-1843

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkasaji682675@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131008000832 NY Practitioner - Family PracticePractitioner - General Surgery 9739313602 Reassigns benefits to 4 organizations
I20190327000225 NC Practitioner - Family PracticePractitioner - General Surgery 9739313602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kasaji Medical PCGroup PAC ID 2466815600, 4 clinicians

Practice addresses (Care Compare)

5820 E W T Harris Blvd
Suite B
Charlotte, NC 28215-3542
Phone (914) 589-9963

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
271425NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Urgent Care of Wantagh PLLC CurrentSince Aug 1, 2013 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine CurrentSince Jan 2, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 2, 2024 Accepting new patients
Excel Urgent Care of NHP PLLC CurrentSince Aug 1, 2013 Accepting new patients
Excel Urgent Care of East Northport, PLLC CurrentSince Aug 1, 2013 Accepting new patients
Excel Urgent Care of Nesconset, PLLC CurrentSince Aug 1, 2013 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Kasaji Medical PC CurrentSince Nov 3, 2022 Accepting new patients
Chenango Memorial Hospital, Inc. Family Medicine Past Accepting new patients

Locations

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

5820 E Wt Harris Blvd
Ste B
Charlotte, NC 28215
Phone (704) 548-7962

558 Larkfield Rd
East Northport, NY 11731
Phone (631) 446-7459

465 Smithtown Blvd
Nesconset, NY 11767
Phone (631) 676-6700

900 Hillside Ave
New Hyde Park, NY 11040
Phone (516) 519-8400

484 Temple Hill Rd
Ste 103
New Windsor, NY 12553

484 Temple Hill Rd
Ste 104
New Windsor, NY 12553
Phone (732) 896-4444

3430 Sunrise Hwy
Wantagh, NY 11793
Phone (516) 900-1600

Interoperability endpoints

  • Direct secure messaging: mkasaji682675@direct.novanthealth.org

Organizations & group practices 9

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1194987677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601843",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 E WT HARRIS BLVD STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282153542",
            "telephone_number": "704-548-7962",
            "fax_number": "704-631-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASAJI",
        "first_name": "MOHAMMAD",
        "middle_name": "KHALIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "271425",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2018-02583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkasaji682675@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "445 S Kings Dr",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.