Individual provider Active NPI

Tiziana Paniagua, MD

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1205083284
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2008-00442 Issued in NC
Practice address
1085 Northeast Gateway Court NE
Suite 200
Concord, NC 28025-2412
Phone
(704) 403-8650
Fax
(704) 403-8655
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2008-00442 NC Primary

Addresses

Primary practice location

1085 Northeast Gateway Court NE
Suite 200
Concord, NC 28025-2412

Mailing address

1085 Northeast Gateway Court NE
Suite 200
Concord, NC 28025-2412
Phone (704) 403-8650

Other identifiers 2

IdentifierTypeStateIssuer
232009OtherNCMEDICARE, ENTITY PTAN
5910501MedicaidNC

Other names 1

  • Tiziana Paniagua Nazer Former name

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
I20081014000453 NC Practitioner - Internal Medicine 8426126780 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008-00442NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients

Locations

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1205083284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1085 NORTHEAST GATEWAY COURT NE",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252412",
            "telephone_number": "704-403-8650",
            "fax_number": "704-403-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 NORTHEAST GATEWAY COURT NE",
            "address_2": "SUITE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252412",
            "telephone_number": "704-403-8650",
            "fax_number": "704-403-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANIAGUA",
        "first_name": "TIZIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2008-00442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE, ENTITY PTAN",
            "identifier": "232009",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5910501",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIZIANA",
            "last_name": "NAZER",
            "middle_name": "PANIAGUA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.