NPIMap

Individual provider Active NPI

Rachael Jan Cecka, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1366050791
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11524 Issued in NC
Practice address
3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117
Phone
(704) 332-1291
NPI assigned
Jul 22, 2020
Last updated
Oct 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-11524 NC Primary
Medical Physician Assistant 363AM0700X 001011524 NC

Addresses

Primary practice location

3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117

Mailing address

PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291

Other practice location 1

2711 Randolph Rd
Suite 305
Charlotte, NC 28207-2027
Phone (704) 334-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026003485 NC Practitioner - Physician Assistant 5799173613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecklenburg Radiology Associates PAGroup PAC ID 6800789587, 95 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6750

1900 Randolph Rd
Suite 602
Charlotte, NC 28207-1122
Phone (704) 332-1291

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4056

3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-2117
Phone (704) 332-1291

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-11524NCMDPhysician Assistant
001011524NCMDMedical Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1366050791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221249",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282221249",
            "telephone_number": "704-332-1291",
            "fax_number": "704-926-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR STE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112117",
            "telephone_number": "704-332-1291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2711 Randolph Rd",
            "address_2": "Suite 305",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282072027",
            "country_code": "US",
            "telephone_number": "704-334-0600",
            "fax_number": "704-334-0615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CECKA",
        "first_name": "RACHAEL",
        "middle_name": "JAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11524",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001011524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.