Victoria Grace Motta, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10913 Issued in NC

Practice address

2620 E 7TH St Ste 200
Charlotte, NC 28204-4314

Phone

(704) 358-9900

Fax

(704) 344-0105

NPI assigned

Apr 28, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Laser and Vein Specialists of the Carolina'S, PLLCGroup PAC ID 9830285568, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: victoria.motta.p1@direct.cup.nextgenshare.com

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.

• Dermatology Laser and Vein Specialists of the Carolina'S, PLLC

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1083700207
  Medicare reassignment Care Compare group
• Gaston Urological Associates, P.a.

  • Urology Physician
  • Gastonia, NC
  • NPI 1437106168
  NPD (past)

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1497376701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 E 7TH ST STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044314",
            "telephone_number": "704-358-9900",
            "fax_number": "704-344-0105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTA",
        "first_name": "VICTORIA",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10913",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elija Moton
• Kadeah Mott
• Madeline Mott
• Rahmana Latisa Mott, NCCPSS
• Alyssa Joy Motta, MSW, LCSW
• Benjamin Motz, MD
• Ann Michelle Moulton, FNP
• Dedrick Earl Moulton, MD
• Kelsey Elizabeth Moulton, FNP-C
• Sanita A Moulton, M.A.C.C., LMFT

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.