Active NPI
Sajeev K Puri, M.D.
- Otolaryngology Physician
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 2005-00997
- Practice address
- 6035 Fairview Rd
Charlotte, NC 28210-3256 - Phone
- (704) 295-3000
- Fax
- (704) 295-3468
- NPI assigned
- Mar 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 2005-00997 | NC | Primary |
Addresses
Primary practice location
6035 Fairview Rd
Charlotte, NC 28210-3256
Mailing address
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20084161 | Other | SC | SELECT HEALTH OF SC |
| 806719 | Other | NC | PARTNERS |
| 5902715 | Medicaid | NC | |
| 3963046 | Other | NC | AETNA |
| 81904 | Other | SC | CHC CARES OF SC |
| N0099A | Medicaid | SC | |
| 1400K | Other | NC | BCBS |
| 326895 | Other | NC | WELLPATH |
| 1934975 | Other | NC | CIGNA |
| E4696 | Other | NC | MEDCOST |
| 000000257099 | Other | SC | UNISON HEALTH PLAN SC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | spuri5773@direct.ceenta.com |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Wake Forest University School of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10405 Centrum Pkwy
Pineville, NC 28134-8825
Phone (704) 295-3650
2325 W Arbors Dr
Suite 201
Charlotte, NC 28262-2664
Phone (704) 295-3500
6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000
724 Aubrey Bell Dr
Matthews, NC 28105-5055
Phone (704) 295-3550
Merit-based Incentive Payment System (MIPS)
- Final score
- 94 of 100
- Quality
- 81.63
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005-00997 | NC | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlotte Eye Ear Nose & Throat Associates, PA | Current | Accepting new patients | |
| Charlotte Eye Ear Nose & Throat Associates, P.a. | Otolaryngology | Current | Accepting new patients |
| Charlotte Eye Ear Nose & Throat Associates, PA | Otolaryngology | Past | Accepting new patients |
Locations
6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078
5933 Blakeney Park Dr
Ste 200
Charlotte, NC 28277
Phone (704) 295-3311
724 Aubrey Bell Dr
Ste 201
Matthews, NC 28105
10405 Centrum Pkwy
Pineville, NC 28134
Phone (704) 295-3650
Interoperability endpoints
- spuri499821@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 3
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.
-
- Ophthalmology Physician
- Charlotte, NC
- NPI 1043287469
Otolaryngology
-
- Ophthalmology Physician
- Salisbury, NC
- NPI 1801217948
-
- Ophthalmology Physician
- Pineville, NC
- NPI 1396930442
Otolaryngology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1538137971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 FAIRVIEW RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103256",
"telephone_number": "704-295-3000",
"fax_number": "704-295-3468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PURI",
"first_name": "SAJEEV",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-10",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NC",
"license": "2005-00997",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "20084161",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "806719",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5902715",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "3963046",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHC CARES OF SC",
"identifier": "81904",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N0099A",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1400K",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLPATH",
"identifier": "326895",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1934975",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "E4696",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNISON HEALTH PLAN SC",
"identifier": "000000257099",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "spuri5773@direct.ceenta.com",
"affiliation": "N",
"address_1": "6035 Fairview Rd",
"city": "Charlotte",
"state": "NC",
"country_code": "US",
"postal_code": "282103256",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.