Individual provider Active NPI

Mahesh Prabhaker Sardesai, M.D.

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1467633057
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2018-01388 Issued in NC
Practice address
10628 Park Rd
Charlotte, NC 28210-8407
Phone
(704) 667-1000
NPI assigned
Nov 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 036-116004 IL
Anesthesiology Physician 207L00000X 42940 KY
Anesthesiology Physician 207L00000X MD443008 PA
Anesthesiology Physician 207L00000X 2018-01388 NC Primary

Addresses

Primary practice location

10628 Park Rd
Charlotte, NC 28210-8407

Mailing address

6135 Park South Dr Ste 510
Charlotte, NC 28210-0100
Phone (704) 749-3116

Other identifiers 1

IdentifierTypeStateIssuer
7100071780MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20110815000787 PA Practitioner - Anesthesiology 8527111244 Reassigns benefits to 1 organization
I20181116002719 NC Practitioner - Anesthesiology 8527111244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Chicago, Pritzker School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHS Anesthesia Services Group IncGroup PAC ID 5799007324, 742 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-116004ILMDAnesthesiology Physician
42940KYMDAnesthesiology Physician
2018-01388NCMDAnesthesiology Physician
MD443008PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Pittsburgh Physicians Anesthesiology CurrentSince Aug 1, 2011 Accepting new patients
University of Pittsburgh Physicians CurrentSince Aug 1, 2011 Accepting new patients
CHS Anesthesia Services Group Inc Anesthesiology CurrentSince Oct 1, 2018 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients

Locations

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

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

815 Freeport Rd
Pittsburgh, PA 15215
Phone (412) 784-4000

5230 Centre Ave
Ste 205
Shadyside, PA 15232
Phone (412) 623-2167

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 and National Provider Directory roles.

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": "1195948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1467633057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6135 PARK SOUTH DR STE 510",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282100100",
            "telephone_number": "704-749-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDESAI",
        "first_name": "MAHESH",
        "middle_name": "PRABHAKER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-25",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036-116004",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "42940",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD443008",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2018-01388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100071780",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.