NPIMap

Individual provider Active NPI

Ageta Muco, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1437424660
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1099698 Issued in NC
Practice address
1025 Morehead Medical Dr
Suite 225
Charlotte, NC 28204-2963
Phone
(704) 355-7150
NPI assigned
Mar 21, 2012
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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 22306 SC
Physician Assistant 363A00000X 1099698 NC Primary

Addresses

Primary practice location

1025 Morehead Medical Dr
Suite 225
Charlotte, NC 28204-2963

Mailing address

PO Box 945395
Atlanta, GA 30394-5395
Phone (888) 820-9533

Other identifiers 3

IdentifierTypeStateIssuer
1455PAMedicaidSC
P01118505OtherNCRAILROAD-MEDICARE
8102489MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120625000012 NC Practitioner - Physician Assistant 6002071164 Reassigns benefits to 2 organizations
I20130802000644 SC Practitioner - Physician Assistant 6002071164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Health Specialty Network IncGroup PAC ID 5193245801, 248 clinicians

Practice addresses (Care Compare)

4525 Cameron Valley Pkwy
Charlotte, NC 28211-4369
Phone (704) 468-8874

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099698NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC CurrentSince Jun 18, 2012 Accepting new patients
American Anesthesiology of North Carolina, PLLC Physician Assistant CurrentSince Jun 18, 2012 Accepting new patients

Locations

1025 Morehead Medical Dr
Ste 225
Charlotte, NC 28204
Phone (704) 248-5516

927 East Blvd
Charlotte, NC 28203
Phone (704) 348-1855

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

1665 Herlong Ct
#B
Rock Hill, SC 29732
Phone (803) 324-1028

Interoperability endpoints

  • Direct secure messaging: amuco136540@carolinashealthcaresystem.direct-ci.com
  • Direct secure messaging: amuco845593@direct.unc.nchie.net

Organizations & group practices 4

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 8

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": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1437424660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 945395",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303945395",
            "telephone_number": "888-820-9533",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "SUITE 225",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042963",
            "telephone_number": "704-355-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCO",
        "first_name": "AGETA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "22306",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1099698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1455PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD-MEDICARE",
            "identifier": "P01118505",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8102489",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.