Individual provider Active NPI

Ashish Kumar Jain, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
National Provider Identifier
1619268430
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
2018-01039 Issued in NC
Practice address
125 Queens Rd Ste 250
Charlotte, NC 28204-3215
Phone
(704) 316-5100
Fax
(704) 316-5101
NPI assigned
Apr 27, 2011
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2018-01039 NC
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 2018-01039 NC Primary

Addresses

Primary practice location

125 Queens Rd Ste 250
Charlotte, NC 28204-3215

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-5100

Other practice location 1

301 Hawthorne Ln Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajain652564@direct.novanthealth.org
Direct Messaging Address ajain652564@direct.novanthealth.org

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
I20190211001910 NC Practitioner - Vascular SurgeryPractitioner - General SurgeryPractitioner - Other (Physician) 0244450351 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, shared by 14 NPIs, 2,413 clinicians

Practice addresses (Care Compare)

106 Corporate Park Dr
Suite 200
Mooresville, NC 28117-7134
Phone (704) 887-4530

401 Mocksville Ave
FL 2
Salisbury, NC 28144-2735
Phone (704) 633-9620

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal14
Leg revascularization (restoring blood flow)31

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 9, 2018 Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 9, 2018 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 1, 2021 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 15, 2023 Accepting new patients
The Presbyterian Hospital CurrentSince Apr 1, 2021 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

125 Baldwin Ave
Ste 200
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Charlotte, NC 28204
Phone (704) 384-5043

125 Queens Rd
Ste 200
Charlotte, NC 28204

125 Queens Rd
Ste 250
Charlotte, NC 28204
Phone (704) 316-2340

15830 Ballantyne Medical Pl
Ste 275
Charlotte, NC 28277
Phone (704) 542-0744

301 Hawthorne Ln
Ste 200
Charlotte, NC 28204
Phone (704) 316-5100

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-2670

8201 Healthcare Loop
Ste 201
Charlotte, NC 28215
Phone (704) 316-3024

9930 Kincey Ave
Ste 200
Huntersville, NC 28078
Phone (704) 887-4530

106 Corporate Park Dr
Ste 200
Mooresville, NC 28117
Phone (704) 235-9090

106 Corporate Park Dr
Ste 300
Mooresville, NC 28117
Phone (704) 887-4530

401 Mocksville Ave
Fl 2
Salisbury, NC 28144
Phone (704) 633-9620

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: ajain652564@direct.novanthealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1619268430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 QUEENS RD STE 250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043215",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 Hawthorne Ln Ste 200",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-316-5100",
            "fax_number": "704-316-5101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAIN",
        "first_name": "ASHISH",
        "middle_name": "KUMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2018-01039",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NC",
            "license": "2018-01039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajain652564@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "301 Hawthorne Ln Ste 200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajain652564@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "125 Queens Rd Ste 250",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.