Individual provider Active NPI

Alexander Philip Iuliano, PA-C

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1356963441
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-09629 Issued in NC
Practice address
3123 N Davidson St Ste 103
Charlotte, NC 28205-1054
Phone
(252) 470-6825
Fax
(704) 559-3367
NPI assigned
May 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0010-09629 NC Primary

Addresses

Primary practice location

3123 N Davidson St Ste 103
Charlotte, NC 28205-1054

Mailing address

3000 Brookmont PL
Charlotte, NC 28210-4802
Phone (704) 962-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220120002691 SC Practitioner - Physician Assistant 8123410347 Reassigns benefits to 1 organization
I20220315001596 NC Practitioner - Physician Assistant 8123410347 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Queens Empire Health CurrentSince Dec 1, 2024 Accepting new patients

Locations

3123 N Davidson St
Ste 103
Charlotte, NC 28205
Phone (252) 470-6825

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1356963441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 BROOKMONT PL",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282104802",
            "telephone_number": "704-962-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 N DAVIDSON ST STE 103",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282051054",
            "telephone_number": "252-470-6825",
            "fax_number": "704-559-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IULIANO",
        "first_name": "ALEXANDER",
        "middle_name": "PHILIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-11",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-09629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.