Individual provider Active NPI

Pallavi Kopparthy, M.D.

  • Hematology & Oncology Physician
  • Raleigh, NC
National Provider Identifier
1285045500
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2022-02587 Issued in NC
Practice address
23 Sunnybrook Rd Ste 220
Raleigh, NC 27610-1855
Phone
(919) 350-2873
NPI assigned
May 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 76250 WI
Student in an Organized Health Care Education/Training Program 390200000X
Hematology & Oncology Physician 207RH0003X 2022-02587 NC Primary

Addresses

Primary practice location

23 Sunnybrook Rd Ste 220
Raleigh, NC 27610-1855

Mailing address

PO Box 603949
Charlotte, NC 28260-3949
Phone (919) 350-0351

Other identifiers 2

IdentifierTypeStateIssuer
1285045500MedicaidWI
1285045500MedicaidNC

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
I20221101000238 NC Practitioner - Hematology/Oncology 4789946369 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

23 Sunnybrook Rd
Raleigh, NC 27610-1855
Phone (919) 350-6002

Hospital & facility affiliations

  • Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
  • Wakemed, Cary Hospital Hospital, Cary, NC, CCN 340173

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76250WIMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group, LLC Hematology & Oncology CurrentSince Oct 10, 2022 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Oct 10, 2022 Accepting new patients
Wakemed PastSince Sep 25, 2022 Accepting new patients

Locations

210 Ashville Ave
Ste 440
Cary, NC 27518
Phone (919) 233-8585

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

23 Sunnybrook Rd
Raleigh, NC 27610
Phone (919) 322-4800

10010 Falls of Neuse Rd
Ste 202
Raleigh, NC 27614
Phone (919) 235-6454

23 Sunnybrook Rd
Ste 220
Raleigh, NC 27610
Phone (919) 350-1269

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1285045500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603949",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603949",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 SUNNYBROOK RD STE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101855",
            "telephone_number": "919-350-2873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPARTHY",
        "first_name": "PALLAVI",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "76250",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2022-02587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285045500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285045500",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.