Individual provider Active NPI

Richard Tae Bach, MD

  • Physical Medicine & Rehabilitation Physician
  • Concord, NC
National Provider Identifier
1386744167
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
2018-01712 Issued in NC
Practice address
487 Lake Concord Rd NE
Concord, NC 28025-2934
Phone
(704) 403-0300
NPI assigned
Sep 22, 2006
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 2018-01712 NC Primary

Addresses

Primary practice location

487 Lake Concord Rd NE
Concord, NC 28025-2934

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

1100 Blythe Blvd
Charlotte, NC 28203-5814
Phone (704) 355-9330

Other practice location 2

10660 Park Rd
Ste 3200
Charlotte, NC 28210-8413
Phone (704) 667-5695

Other practice location 3

275 Beatty Dr
Belmont, NC 28012-2715
Phone (704) 355-9330

Other practice location 4

10648 Park Rd
Charlotte, NC 28210-8407
Phone (704) 355-9330

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address rbach387406@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100414000376 NJ Practitioner - Physical Medicine and Rehabilitation 6901794858 Reassigns benefits to 1 organization
I20191002001822 NC Practitioner - Physical Medicine and Rehabilitation 6901794858 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 667-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2018-01712NCMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center Current Accepting new patients
North Atlantic Pain and Rehab Associates, LLC Physical Medicine & Rehabilitation CurrentSince Apr 19, 2000 Accepting new patients
Carolinas Pathology Group, PA Current Accepting new patients
Carolinas Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Carolinas Medical Center CurrentSince Apr 13, 2020 Accepting new patients
Center for Advanced Pain Management and Wellness, LLC PastSince Sep 17, 2023 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

275 Beatty Dr
Belmont, NC 28012
Phone (704) 355-9330

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10648 Park Rd
Charlotte, NC 28210
Phone (704) 355-9330

10660 Park Rd
Ste 3200
Charlotte, NC 28210
Phone (704) 667-2500

1100 Blythe Blvd
Charlotte, NC 28203
Phone (704) 355-4300

487 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 403-0100

560 Berkeley Ave
Orange, NJ 07050
Phone (973) 672-6500

799 Bloomfield Ave
Ste 212
Verona, NJ 07044
Phone (908) 754-4900

799 Bloomfield Ave
Ste 303
Verona, NJ 07044
Phone (973) 857-7800

Interoperability endpoints

  • Direct secure messaging: rbach191565@ahs.direct-ci.com
  • Direct secure messaging: rbach387406@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 9

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": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1386744167",
    "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": "487 LAKE CONCORD RD NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252934",
            "telephone_number": "704-403-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-355-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "704-667-5695",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Beatty Dr",
            "address_purpose": "LOCATION",
            "city": "Belmont",
            "state": "NC",
            "postal_code": "280122715",
            "country_code": "US",
            "telephone_number": "704-355-9330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10648 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108407",
            "country_code": "US",
            "telephone_number": "704-355-9330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BACH",
        "first_name": "RICHARD",
        "middle_name": "TAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "2018-01712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbach387406@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "487 Lake Concord Rd NE",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.