Puja Dalal

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2021-03040 Issued in NC

Practice address

19485 Old Jetton Rd Ste 100
Cornelius, NC 28031-6583

Phone

(704) 316-5170

Fax

(704) 316-5172

NPI assigned

Apr 18, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, SC, NC3 enrollments

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 3

Specialty

Family Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pdalal1013166@direct.novanthealth.org

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.

• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment Care Compare group NPD
• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Kent, WA
  • NPI 1831199454

  Family Medicine

  Medicare reassignment NPD
• Prisma Health Medical Group-Midlands

  • Multi-Specialty Clinic/Center
  • Columbia, SC
  • NPI 1275988321

  Family Medicine

  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Family Medicine Physician
  • Cornelius, NC
  • NPI 1255709432
  NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Kent, WA
  • NPI 1144703885
  NPD
• Prisma Health Medical Group-Midlands

  • Plastic and Reconstructive Surgery Physician
  • Sumter, SC
  • NPI 1447749510

  Family Medicine

  NPD
• Prisma Health Medical Group-Midlands

  • Durable Medical Equipment & Medical Supplies
  • Columbia, SC
  • NPI 1881469856
  NPD
• Novant Health Medical Group, LLC

  • Internal Medicine Physician
  • Charlotte, NC
  • NPI 1134841802
  NPD (past)

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1326468299",
    "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": "19485 OLD JETTON RD STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316583",
            "telephone_number": "704-316-5170",
            "fax_number": "704-316-5172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Madison St",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041316",
            "country_code": "US",
            "telephone_number": "206-386-6054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "219 State Ave N Ste 100",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980304543",
            "country_code": "US",
            "telephone_number": "253-372-3602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3209 Colonial Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292036930",
            "country_code": "US",
            "telephone_number": "803-434-6113",
            "fax_number": "803-434-7231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALAL",
        "first_name": "PUJA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60662882",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "83915",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-03040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Cruz
• Grace Isabelle Cummins, PT, DPT
• Jennifer Townsend Cunningham, LCMHCA
• Cindy Custer, RD
• Custom Asset Partners, LLC
• Jenna Katelyn Daley, LCSW
• James David Dalmas, DAVID DALMAS, RPH
• Kathryn Grayce Dandrea, CRNA
• Daniel Scott Danford, DO
• Daniel D Skotzko DDS PA

• Family Medicine Physician in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.

Verify at the official NPI Registry.