Noel Desantos Ibanez, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2010-01897 Issued in NC

Practice address

16740 Davidson Concord Rd
Davidson, NC 28036-8746

Phone

(704) 444-2400

NPI assigned

Dec 7, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 9

Addresses

Electronic endpoints 2

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

Specialty

Psychiatry

Education

West Virginia University School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nibanez500070@carolinashealthcaresystem.direct-ci.com

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.

• Carolinas Medical Center

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment Care Compare group NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group NPD
• Carolinas Medical Center

  • Child & Adolescent Psychiatry Physician
  • Charlotte, NC
  • NPI 1356689996
  NPD
• Carolinas Medical Center

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Child & Adolescent Psychiatry Physician
  • Harrisburg, NC
  • NPI 1043646961
  NPD
• The Charlotte-Mecklenburg Hospital Authority

  • Rehabilitation Hospital Unit
  • Charlotte, NC
  • NPI 1962987131
  NPD
• Carolinas Medical Center

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  NPD (past)
• Valley Comprehensive Community Mental Health Center

  • Community/Behavioral Health Agency
  • Morgantown, WV
  • NPI 1154740660
  NPD (past)
• Valley Comprehensive Community Mental Health Center, Inc.

  • Mental Health Counselor
  • Morgantown, WV
  • NPI 1861476350
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1639407448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16740 DAVIDSON CONCORD RD",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280368746",
            "telephone_number": "704-444-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 Billingsley Rd",
            "address_2": "Cottage A",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28211",
            "country_code": "US",
            "telephone_number": "704-444-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5427 Nc Highway 49 S",
            "address_2": "Ste 105",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757408",
            "country_code": "US",
            "telephone_number": "704-454-7268",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Billingsley Rd",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282111009",
            "country_code": "US",
            "telephone_number": "704-444-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IBANEZ",
        "first_name": "NOEL",
        "middle_name": "DESANTOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-07",
        "last_updated": "2024-07-24",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "NC",
            "license": "2010-01897",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2010-01897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nibanez500070@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "16740 Davidson Concord Rd",
            "city": "Davidson",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280368746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Candace Afrika Howell, MD
• Ansle Sifford Hudson, RD
• Sara Hudson, LICSW, LCSW
• Tonya M. Hudson, MD
• Huntersville Health & Wellness, Inc
• Inspire Chiropractic & Wellness
• Julie Megan Izykowski, SLP
• Brandi Rochelle Jackson, DDS
• Candace Rowe Jackson, PTA
• Aime A. Janawsky

• Psychiatry Physician in Davidson, NC
• Providers in Davidson, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.

Verify at the official NPI Registry.