Individual provider Active NPI

Jason P Gajdzis, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1649361239
Registry record updated Jan 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-05087 Issued in NC
Practice address
15825 Ballantyne Medical PL
#100
Charlotte, NC 28277-4652
Phone
(704) 323-3400
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2015

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 0010-05087 NC Primary

Addresses

Primary practice location

15825 Ballantyne Medical PL
#100
Charlotte, NC 28277-4652

Mailing address

4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141126001950 NC Practitioner - Physician Assistant 7810994662 Reassigns benefits to 1 organization
I20170421000558 SC Practitioner - Physician Assistant 7810994662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 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

601 Sutton Rd S
Fort Mill, SC 29715-8439
Phone (803) 328-6306

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-05087NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina, PA Physician Assistant CurrentSince Sep 2, 2014 Accepting new patients
Orthocarolina Physician Assistant CurrentSince Sep 2, 2014 Accepting new patients
Orthocarolina Physician Assistant Past Accepting new patients
Reconstructive Orthopaedic Associates II LLC Past Accepting new patients

Locations

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

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

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

601 Sutton Rd S
Ste 101
Fort Mill, SC 29715
Phone (803) 328-6306

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

6237 Carolina Commons Dr
Ste 110
Indian Land, SC 29707
Phone (803) 266-7547

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421884800000",
    "number": "1649361239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "SUITE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 BALLANTYNE MEDICAL PL",
            "address_2": "#100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282774652",
            "telephone_number": "704-323-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAJDZIS",
        "first_name": "JASON",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.