Saritha Ambati, MD
Individual provider Active NPI Pediatrics Physician · Charlotte, NC
NPI 1275596124 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1275596124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 2008-01077 (NC)
- Practice address
- 101 E W T Harris Blvd
Ste 1121
Charlotte, NC 28262-3485 - Phone
- (704) 717-2000
- NPI assigned
- Apr 11, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231011001227 | NC | Practitioner - Pediatric Medicine | 5193170173 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2008-01077 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physician Network Inc | Pediatrics | Current |
Accepting new patients |
| University Pediatrics | Pediatrics | Current |
Accepting new patients |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| University Pediatrics | Pediatrics | Current |
Accepting new patients |
| University Pediatrics | Pediatrics | Past |
Accepting new patients |
| Lung Center LLC | Past | Accepting new patients | |
| Carolinas Physicians Network, Inc | Past | Accepting new patients | |
| The Children'S Clinic | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
101 E Wt Harris Blvd
Charlotte, NC 28262
Phone (704) 863-0640
101 E Wt Harris Blvd
Ste 1121
Charlotte, NC 28262
Phone (704) 717-2000
5727 Prosperity Crossing Dr
Ste 1500
Charlotte, NC 28269
Phone (704) 717-2000
Interoperability endpoints
- sambati1234176@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2008-01077 | NC | Yes |
Addresses
Primary practice location
101 E W T Harris Blvd
Ste 1121
Charlotte, NC 28262-3485
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Other practice location 1
5727 Prosperity Crossing Dr
Ste 1500
Charlotte, NC 28269-2206
Phone (704) 863-9910
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
| Direct Messaging Address | sambati1234176@CarolinasHealthcareSystem.direct-ci.com | Atrium Health |
NPI Registry JSON
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1275596124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19305",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282199305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E W T HARRIS BLVD",
"address_2": "STE 1121",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282623485",
"telephone_number": "704-717-2000"
}
],
"practiceLocations": [
{
"address_1": "5727 Prosperity Crossing Dr",
"address_2": "Ste 1500",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282692206",
"country_code": "US",
"telephone_number": "704-863-9910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AMBATI",
"first_name": "SARITHA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-11",
"last_updated": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2008-01077",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "ABILITY Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sambati1234176@CarolinasHealthcareSystem.direct-ci.com",
"affiliation": "Y",
"affiliationName": "Atrium Health",
"address_1": "101 E W T Harris Blvd",
"address_2": "Ste 1121",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282623485",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
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All providers in Charlotte, NC · Pediatrics Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.