Individual provider Active NPI

Vincent A Cordero, MD

  • Anesthesiology Physician
  • Charlotte, NC
National Provider Identifier
1508091323
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2013-00607 Issued in NC
Practice address
1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone
(704) 355-2000
NPI assigned
May 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2013-00607 NC Primary

Addresses

Primary practice location

1000 Blythe Blvd
Charlotte, NC 28203-5812

Mailing address

3100 Spring Forest Rd Ste 130
Raleigh, NC 27616-2880
Phone (919) 873-9533

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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
I20130716000129 NC Practitioner - Anesthesiology 6305086356 Reassigns benefits to 3 organizations
I20200729000096 SC Practitioner - Anesthesiology 6305086356 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2009
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)

118 Professional Park Dr
Rock Hill, SC 29732-1178
Phone (803) 329-3124

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6000

Hospital & facility affiliations

  • Atrium Health Union Hospital, Monroe, NC, CCN 340130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-00607NCMDAnesthesiology Physician
82125SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Anesthesiology Consultants, PLLC Anesthesiology CurrentSince Jul 8, 2013 Accepting new patients
Southeast Anesthesiology Consultants, PLLC Anesthesiology CurrentSince Jul 8, 2013 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology Current Accepting new patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince Jul 15, 2020 Accepting new patients
CHS Anesthesia Services Group Inc Anesthesiology CurrentSince Dec 15, 2015 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 31, 2018 Accepting new patients
CHS Anesthesia Services Group Inc Anesthesiology PastSince Oct 25, 2020 Accepting new patients

Locations

1500 Concord Ter
Fl 5
Sunrise, FL 33323
Phone (954) 384-0175

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

16455 Statesville Rd
Huntersville, NC 28078
Phone (704) 801-3719

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

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

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

118 Professional Park Dr
Rock Hill, SC 29732
Phone (803) 329-3124

Organizations & group practices 7

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 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": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1508091323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-873-9533",
            "fax_number": "844-454-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BLYTHE BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035812",
            "telephone_number": "704-355-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "VINCENT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-22",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NC",
            "license": "2013-00607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.