Individual provider Active NPI

Kurt Thomas Scavelli, M.D.

  • Ophthalmology Physician
  • Raleigh, NC
National Provider Identifier
1427408228
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2022-01043 Issued in NC
Practice address
4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514
Phone
(919) 782-8038
Fax
(919) 782-8189
NPI assigned
Jun 13, 2016
Last updated
Jul 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT211057 PA
Ophthalmology Physician 207W00000X 60971 TN
Ophthalmology Physician 207W00000X 2022-01043 NC Primary
Retina Specialist (Ophthalmology) Physician 207WX0107X 2022-01043 NC

Addresses

Primary practice location

4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514

Mailing address

4414 Lake Boone TRL Ste 302
Raleigh, NC 27607-7514
Phone (919) 782-8038

Other identifiers 1

IdentifierTypeStateIssuer
1427408228MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kscavelli@northcarolinaretina.intellechartdirect.net Direct Retina Associates, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220803001848 NC Practitioner - Ophthalmology 8628493236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Retina Associates, PLLCGroup PAC ID 3870498876, 18 clinicians

Practice addresses (Care Compare)

4414 Lake Boone TRL
Suite 302
Raleigh, NC 27607-7514
Phone (919) 782-8038

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT211057PAMDInternal Medicine Physician
2022-01043NCMDRetina Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Retina Associates, PLLC Ophthalmology CurrentSince Aug 22, 2022 Accepting new patients
Medical Eye Associates PA Ophthalmology CurrentSince Aug 1, 2022 Accepting new patients

Locations

4414 Lake Boone Trl
Ste 302
Raleigh, NC 27607
Phone (919) 782-8038

5900 Six Forks Rd
Ste 105
Raleigh, NC 27609
Phone (919) 782-8038

1707 Medical Park Dr W
Ste 1
Wilson, NC 27893
Phone (252) 291-7008

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kscavelli@northcarolinaretina.intellechartdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1427408228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-782-8038",
            "fax_number": "919-782-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRL STE 302",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077514",
            "telephone_number": "919-782-8038",
            "fax_number": "919-782-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAVELLI",
        "first_name": "KURT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-13",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT211057",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "60971",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2022-01043",
            "primary": true
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NC",
            "license": "2022-01043",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427408228",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscavelli@northcarolinaretina.intellechartdirect.net",
            "affiliation": "Y",
            "affiliationName": "Retina Associates, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4414 Lake Boone Trl Ste 302",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276077514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.