Individual provider Active NPI

Cassandra Marie Ottaviano, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1215237979
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11588 Issued in NC
Practice address
6060 Piedmont Row Dr S Ste 500
Charlotte, NC 28287-3803
Phone
(855) 501-1004
NPI assigned
Oct 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11588 NC Primary

Addresses

Primary practice location

6060 Piedmont Row Dr S Ste 500
Charlotte, NC 28287-3803

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (855) 501-1004

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241121004204 NC Practitioner - Physician Assistant 8628403524 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
014296NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 7, 2024 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Physician Assistant CurrentSince Nov 9, 2025 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Oct 7, 2024 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

6060 Piedmont Row Dr S
Ste 500
Charlotte, NC 28287
Phone (980) 326-3277

1021 Morehead Medical Dr
Ste A
Charlotte, NC 28204
Phone (704) 355-2884

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.

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1215237979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "855-501-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6060 PIEDMONT ROW DR S STE 500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282873803",
            "telephone_number": "855-501-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTAVIANO",
        "first_name": "CASSANDRA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.