Individual provider Active NPI

Justin Bilancia, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1386661940
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2026008856 Issued in MO
Practice address
1350 S Kings Dr
Charlotte, NC 28207-2134
Phone
(704) 446-4490
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9361 MA
Physician Assistant 363A00000X 2026008856 MO Primary
Physician Assistant 363A00000X 0010-05245 NC
Physician Assistant 363A00000X MA063564 PA

Addresses

Primary practice location

1350 S Kings Dr
Charlotte, NC 28207-2134

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (774) 443-7552

Other practice location 2

1001 Blythe Blvd
Charlotte, NC 28203-5866
Phone (704) 355-5100

Other practice location 3

1437 Scott Ave
Charlotte, NC 28203-5843
Phone (704) 446-5860

Other practice location 4

1918 Randolph Rd Ste 580
Charlotte, NC 28207-1116
Phone (704) 384-9900

Other practice location 5

119 Belmont St
Worcester, MA 01605-2903
Phone (774) 443-7552

Other practice location 6

10650 Park Rd
Suite 300
Charlotte, NC 28210-8538
Phone (704) 667-3960

Other identifiers 1

IdentifierTypeStateIssuer
104054970-0004MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA, PA, MA, MO5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20150623000862 NC Practitioner - Physician Assistant 6800993510 Reassigns benefits to 4 organizations
I20211206001491 GA Practitioner - Physician Assistant 6800993510 Reassigns benefits to 1 organization
I20220614001096 PA Practitioner - Physician Assistant 6800993510 Reassigns benefits to 3 organizations
I20230523000826 MA Practitioner - Physician Assistant 6800993510 Reassigns benefits to 1 organization
I20260408003776 MO Practitioner - Physician Assistant 6800993510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9361MAMDPhysician Assistant
2026008856MOMDPhysician Assistant
0010-05245NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince Mar 5, 2025 Accepting new patients
Fayette Physician Network Inc CurrentSince Jul 1, 2024 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 24, 2022 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Fayette Physician Network Inc Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 13, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Jan 1, 2025 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 13, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Mar 5, 2025 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 24, 2022 Accepting new patients
Family Care Centers Inc. CurrentSince Jun 8, 2023 Accepting new patients
East Carolina University Past Accepting new patients
Fayette Physician Network Inc Past Accepting new patients
Pulmonary Associates PC Past Accepting new patients

Locations

1918 Randolph Rd
Ste 580
Charlotte, NC 28207
Phone (704) 333-9113

115 Heart Dr
Greenville, NC 27834
Phone (252) 744-4400

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

2100 Mack Blvd
Fl 4
Allentown, PA 18103

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

772 E Broad St
Hazleton, PA 18201
Phone (570) 501-1242

320 W Pumping Station Rd
Quakertown, PA 18951
Phone (215) 529-4240

201 Mary Higginson Ln
Uniontown, PA 15401
Phone (724) 430-5940

500 W Berkeley St
Uniontown, PA 15401
Phone (724) 430-5000

Interoperability endpoints

  • Direct secure messaging: jbilancia96517@tuftsmedicine.direct-ci.com
  • Direct secure messaging: jbilancia1534214@direct.novanthealth.org

Organizations & group practices 21

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.

View all 21

Hospital & facility affiliations 2

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1386661940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 S KINGS DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282072134",
            "telephone_number": "704-446-4490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "774-443-7552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-355-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1437 Scott Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035843",
            "country_code": "US",
            "telephone_number": "704-446-5860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1918 Randolph Rd Ste 580",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071116",
            "country_code": "US",
            "telephone_number": "704-384-9900",
            "fax_number": "704-384-9919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "119 Belmont St",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052903",
            "country_code": "US",
            "telephone_number": "774-443-7552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10650 Park Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BILANCIA",
        "first_name": "JUSTIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9361",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2026008856",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05245",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA063564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104054970-0004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.