Individual provider Active NPI

Martin Bernard Cutrone Jr., MD

  • Cardiovascular Disease Physician
  • Charlotte, NC
National Provider Identifier
1619975752
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
200301104 Issued in NC
Practice address
14035 Grandiflora Dr
Charlotte, NC 28278-8456
Phone
(704) 316-1074
Fax
(704) 316-1077
NPI assigned
Jul 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200301104 NC
Interventional Cardiology Physician 207RI0011X 2003-01104 NC
Cardiovascular Disease Physician 207RC0000X 200301104 NC Primary

Addresses

Primary practice location

14035 Grandiflora Dr
Charlotte, NC 28278-8456

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 316-1074

Other practice location 1

1718 E 4th St Ste 501
Charlotte, NC 28204-3197
Phone (704) 343-9800

Other practice location 2

13425 Hoover Creek Blvd
Ste 101
Charlotte, NC 28273-0054
Phone (704) 343-9800

Other identifiers 2

IdentifierTypeStateIssuer
N01104MedicaidSC
89135EFMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mcutrone34622@direct.novanthealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2003-01104NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Presbyterian Hospital Past Accepting new patients
Paul E Lemanski MD PLLC Internal Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mcutrone34622@direct.novanthealth.org

Organizations & group practices 2

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1619975752",
    "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": "704-316-1074",
            "fax_number": "704-316-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14035 GRANDIFLORA DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282788456",
            "telephone_number": "704-316-1074",
            "fax_number": "704-316-1077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 E 4th St Ste 501",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043197",
            "country_code": "US",
            "telephone_number": "704-343-9800",
            "fax_number": "704-347-2011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13425 Hoover Creek Blvd",
            "address_2": "Ste 101",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282730054",
            "country_code": "US",
            "telephone_number": "704-343-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CUTRONE",
        "first_name": "MARTIN",
        "middle_name": "BERNARD",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-12",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200301104",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2003-01104",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NC",
            "license": "200301104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01104",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89135EF",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcutrone34622@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4500 Cameron Valley Pkwy Ste 100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282113542",
            "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 Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.