Individual provider Active NPI

Raymond Thertulien, M.D.

  • Hematology (Internal Medicine) Physician
  • Charlotte, NC
National Provider Identifier
1275759581
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology (Internal Medicine) PhysicianTaxonomy code 207RH0000X
License
2007-00361 Issued in NC
Practice address
125 Queens Rd Ste 610
Charlotte, NC 28204-3580
Phone
(980) 302-6600
Fax
(980) 302-6605
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2007-00361 NC
Hematology & Oncology Physician 207RH0003X 2007-00361 NC
Hematology (Internal Medicine) Physician 207RH0000X 2007-00361 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 610
Charlotte, NC 28204-3580

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

20 Medical Park Dr
Suite B
Asheville, NC 28803-2493
Phone (828) 254-8232

Other practice location 2

600 Hospital Dr Ste 10B
Clyde, NC 28721-8024
Phone (828) 456-5214

Other practice location 3

179 N Buncombe School Rd Ste 102
Weaverville, NC 28787-9699
Phone (828) 645-3100

Other practice location 4

50 Hospital Dr Ste 4B
Hendersonville, NC 28792-5246
Phone (828) 681-2917

Other identifiers 5

IdentifierTypeStateIssuer
P01028293OtherNCRAILROAD MEDICARE
7964243OtherNCAETNA
143705001MedicaidAR
5906570MedicaidNC
4510132OtherNCCIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rthertulien1036478@direct.novanthealth.org

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
I20070822000947 NC Practitioner - Hematology/OncologyPractitioner - Hematopoietic Cell Transplantation and Cellular Therapy 8022100023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Hematopoietic Cell Transplantation and Cellular Therapy
Education
University of Rochester School of Medicine and Dentistry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Presbyterian HospitalGroup PAC ID 1153231907, 412 clinicians

Practice addresses (Care Compare)

125 Queens Rd
Suite 600
Charlotte, NC 28204-3215
Phone (980) 302-6600

Hospital & facility affiliations

  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053
  • Novant Health Matthews Medical Center Hospital, Matthews, NC, CCN 340171
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Internal Medicine CurrentSince Mar 1, 2022 Accepting new patients
The Presbyterian Hospital CurrentSince Mar 1, 2022 Accepting new patients
The Presbyterian Hospital Internal Medicine Current Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Queens Rd
Ste 600
Charlotte, NC 28204
Phone (980) 302-6600

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

125 Queens Rd
Ste 640
Charlotte, NC 28204
Phone (980) 302-6761

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

125 Queens Rd
Ste 610
Charlotte, NC 28204
Phone (980) 302-6600

Interoperability endpoints

  • Direct secure messaging: rthertulien1036478@direct.novanthealth.org

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1275759581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 610",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043580",
            "telephone_number": "980-302-6600",
            "fax_number": "980-302-6605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Medical Park Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Asheville",
            "state": "NC",
            "postal_code": "288032493",
            "country_code": "US",
            "telephone_number": "828-254-8232",
            "fax_number": "828-253-4470",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 Hospital Dr Ste 10B",
            "address_purpose": "LOCATION",
            "city": "Clyde",
            "state": "NC",
            "postal_code": "287218024",
            "country_code": "US",
            "telephone_number": "828-456-5214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "179 N Buncombe School Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Weaverville",
            "state": "NC",
            "postal_code": "287879699",
            "country_code": "US",
            "telephone_number": "828-645-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Hospital Dr Ste 4B",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287925246",
            "country_code": "US",
            "telephone_number": "828-681-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERTULIEN",
        "first_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2007-00361",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2007-00361",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "NC",
            "license": "2007-00361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01028293",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7964243",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143705001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906570",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4510132",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rthertulien1036478@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 600",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.