Rajitha Ambati, MD
Individual provider Active NPI Internal Medicine Physician · Gastonia, NC
NPI 1366601262 · NPPES record last updated Oct 21, 2016
Key facts
- NPI
- 1366601262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 2015-01926 (NC)
- Practice address
- 2555 Court Dr
Suite 270
Gastonia, NC 28054-2134 - Phone
- (704) 834-4390
- Fax
- (704) 834-3274
- NPI assigned
- Jun 5, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Caromont Medical Group Inc
Practice addresses (Care Compare)
2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450
660 Summit Crossing PL
Suite 301
Gastonia, NC 28054-2181
Phone (704) 854-8799
Hospital & facility affiliations
- Caromont Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161227001126 | NC | Practitioner - Internal Medicine | 3476624198 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015-01926 | NC | MD | Internal Medicine Physician |
| 35.091454 | OH | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caromont Medical Group, Inc. | Current |
Accepting new patients | |
| Caromont Medical Group Inc | Current |
Accepting new patients | |
| Caromont Medical Group Inc | Internal Medicine | Current | Accepting new patients |
| Caromont Medical Group Inc | Past | Accepting new patients |
Locations
2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662
2555 Court Dr
Ste 270
Gastonia, NC 28054
Phone (704) 671-7650
660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799
2240 Remount Rd
Gastonia, NC 28054
Phone (704) 671-5311
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35.091454 | OH | |
| Internal Medicine Physician | 207R00000X | 2015-01926 | NC | Yes |
Addresses
Primary practice location
2555 Court Dr
Suite 270
Gastonia, NC 28054-2134
Mailing address
2555 Court Dr
Suite 270
Gastonia, NC 28054-2134
Phone (704) 834-4390
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366601262 | Medicaid | NC |
Other providers in Gastonia, NC
- Alternative Community Penalties Program, Inc.
- Mikayla Cheyenne Altman
- Rebecca Altman
- Kimberly McKay Alves
- Alyssa M Wolff DDS PLLC
- Elaine Ambrosio
- America'S Best Contacts & Eyeglasses
- American Homepatient, Inc.
- Shailaja Amirishetty
- Corrine M Andersen
All providers in Gastonia, NC · Internal Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.