Active NPI
Raymond Thertulien, M.D.
- Hematology (Internal Medicine) Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Internal Medicine) Physician
- License
- 2007-00361
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01028293 | Other | NC | RAILROAD MEDICARE |
| 7964243 | Other | NC | AETNA |
| 143705001 | Medicaid | AR | |
| 5906570 | Medicaid | NC | |
| 4510132 | Other | NC | CIGNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hematology/Oncology
- 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
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
- Novant Health Matthews Medical Center
- Novant Health Huntersville Medical Center
- Carolinas Medical Center/Behav Health
- Novant Health Mint Hill Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Presbyterian Hospital | Internal Medicine | Current | Accepting new patients |
| The Presbyterian Hospital | Current | 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
- 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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Charlotte, NC
- NPI 1053365817
-
- Cardiovascular Disease Physician
- Charlotte, NC
- NPI 1457695264
-
- Internal Medicine Physician
- Charlotte, NC
- NPI 1740169820
-
- Interventional Cardiology Physician
- Charlotte, NC
- NPI 1205836434
Hospital & facility affiliations 13
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1053358945
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1295789907
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1376985135
-
- Children's Rehabilitation Hospital
- Charlotte, NC
- NPI 1699829887
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1720029705
Hospital
-
- General Acute Care Hospital
- Matthews, NC
- NPI 1063463156
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1972001469
-
- General Acute Care Hospital
- Huntersville, NC
- NPI 1346291309
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1396798591
Hospital
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1497708838
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1881647204
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.