Individual provider Active NPI

Sajeev K Puri, M.D.

  • Otolaryngology Physician
  • Charlotte, NC
National Provider Identifier
1538137971
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2005-00997 Issued in NC
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

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
20084161OtherSCSELECT HEALTH OF SC
806719OtherNCPARTNERS
5902715MedicaidNC
3963046OtherNCAETNA
81904OtherSCCHC CARES OF SC
N0099AMedicaidSC
1400KOtherNCBCBS
326895OtherNCWELLPATH
1934975OtherNCCIGNA
E4696OtherNCMEDCOST
000000257099OtherSCUNISON HEALTH PLAN SC

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000390 NC Practitioner - Otolaryngology 2961433966 Reassigns benefits to 1 organization

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 100Reported as apm
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

LicenseStateTypeSpecialty
2005-00997NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, PA CurrentSince Aug 15, 2005 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Otolaryngology CurrentSince Aug 15, 2005 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA Otolaryngology PastSince Apr 13, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.