Individual provider Active NPI

Sayed Imtiaz

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1487049789
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2026-04046 Issued in NC
Practice address
125 Queens Rd Ste 430
Charlotte, NC 28204-3579
Phone
(980) 302-6300
Fax
(980) 302-6305
NPI assigned
Apr 2, 2015
Last updated
Jul 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 2026-04046 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 430
Charlotte, NC 28204-3579

Mailing address

515 George Washington Way
Richland, WA 99352-4420
Phone (509) 946-6117

Other practice location 1

450 Clarkson Ave
Brooklyn, NY 11203-2098
Phone (718) 270-4222

Other identifiers 1

IdentifierTypeStateIssuer
1487049789MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3545 Whitehall Park Dr
Suite 300
Charlotte, NC 28260-4281

PO Box
Charlotte, NC 28260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2026-04046NCMDSurgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1487049789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 GEORGE WASHINGTON WAY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524420",
            "telephone_number": "509-946-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 430",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043579",
            "telephone_number": "980-302-6300",
            "fax_number": "980-302-6305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Clarkson Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112032098",
            "country_code": "US",
            "telephone_number": "718-270-4222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IMTIAZ",
        "first_name": "SAYED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-02",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2026-04046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487049789",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.