NPIMap

Individual provider Active NPI

Lalita Shraavya Mandavilli, MD

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1649504176
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2013-01208 Issued in NC
Practice address
10628 Park Rd
Charlotte, NC 28210-8407
Phone
(704) 667-7070
NPI assigned
Sep 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 2013-01208 NC
Internal Medicine Physician 207R00000X 2013-01208 NC Primary

Addresses

Primary practice location

10628 Park Rd
Charlotte, NC 28210-8407

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

920 Church St N
Suite 255
Concord, NC 28025-2927
Phone (704) 403-1331

Other practice location 2

8800 N Tryon St
Charlotte, NC 28262-3300
Phone (704) 863-6241

Other practice location 3

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-0720

Other practice location 4

2001 Vail Ave
Charlotte, NC 28207-1248
Phone (704) 304-6070

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address lmandavilli224195@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130826000802 NC Practitioner - HospitalistPractitioner - Internal Medicine 5698922276 Reassigns benefits to 1 organization
I20221228000142 SC Practitioner - Internal Medicine 5698922276 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

10628 Park Rd
Charlotte, NC 28210-8407
Phone (704) 351-9422

Hospital & facility affiliations

  • Atrium Health Pineville Hospital, Charlotte, NC, CCN 340098
  • Atrium Health Union Hospital, Monroe, NC, CCN 340130
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2013-01208NCMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Medical Group, PLLC Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Palmetto Medical Group, PLLC Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Valeant Medical Group PLLC Internal Medicine CurrentSince Jun 12, 2023 Accepting new patients
Carolinas Physicians Network Inc Hospitalist CurrentSince Dec 1, 2017 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Dec 1, 2017 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

920 Church St N
Ste 255
Concord, NC 28025
Phone (704) 403-1331

1040 Edgewater Corporate Pkwy
Ste 101
Indian Land, SC 29707
Phone (803) 548-7007

1795 Frank Gaston Blvd
Rock Hill, SC 29732
Phone (516) 849-8385

Interoperability endpoints

  • Direct secure messaging: lmandavilli224195@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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 9

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": "1254268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1649504176",
    "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": "10628 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108407",
            "telephone_number": "704-667-7070"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Church St N",
            "address_2": "Suite 255",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252927",
            "country_code": "US",
            "telephone_number": "704-403-1331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8800 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623300",
            "country_code": "US",
            "telephone_number": "704-863-6241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-0720",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Vail Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071248",
            "country_code": "US",
            "telephone_number": "704-304-6070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDAVILLI",
        "first_name": "LALITA",
        "middle_name": "SHRAAVYA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-30",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NC",
            "license": "2013-01208",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-01208",
            "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": "lmandavilli224195@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10628 Park Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.