NPIMap

Individual provider Active NPI

Alexandria Nicole Kinzel, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1619461811
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-13449 Issued in NC
Practice address
15825 Ballantyne Medical PL Ste 100
Charlotte, NC 28277-0745
Phone
(704) 323-3400
NPI assigned
Jun 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-13449 NC Primary

Addresses

Primary practice location

15825 Ballantyne Medical PL Ste 100
Charlotte, NC 28277-0745

Mailing address

4601 Park Rd Ste 300
Charlotte, NC 28209-2290
Phone (704) 323-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC, SC3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190405000433 CA Practitioner - Physician Assistant 9032450796 Reassigns benefits to 1 organization
I20231204002022 NC Practitioner - Physician Assistant 9032450796 Reassigns benefits to 1 organization
I20250606002707 SC Practitioner - Physician Assistant 9032450796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

1915 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 323-2282

2536 Lengers Way
Fort Mill, SC 29707-7126
Phone (803) 313-3294

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
5209SCMDProfessional Counselor
0010-13449NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Physician Assistant CurrentSince Nov 20, 2023 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Nov 20, 2023 Accepting new patients

Locations

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

15825 Ballantyne Medical Pl
Ste 100
Charlotte, NC 28277
Phone (704) 323-3400

2536 Lengers Way
Indian Land, SC 29707
Phone (803) 313-3294

Organizations & group practices 5

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 10

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1619461811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282092290",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 BALLANTYNE MEDICAL PL STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282770745",
            "telephone_number": "704-323-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINZEL",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-13449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.