Individual provider Active NPI

Poras Kamlesh Patel

  • Hematology & Oncology Physician
  • Huntersville, NC
National Provider Identifier
1669876447
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
2020-02069 Issued in NC
Practice address
9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone
(704) 947-5005
Fax
(877) 881-8455
NPI assigned
Oct 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

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 285941 NY
Medical Oncology Physician 207RX0202X 2020-02069 NC
Hematology & Oncology Physician 207RH0003X 2020-02069 NC Primary

Addresses

Primary practice location

9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541

Mailing address

9930 Kincey Ave Ste 165
Huntersville, NC 28078-6541
Phone (704) 947-5005

Other practice location 1

146 Medical Park Rd Ste 212
Mooresville, NC 28117-8529
Phone (704) 659-7850

Other practice location 2

10320 Mallard Creek Rd Ste 100
Charlotte, NC 28262-5204
Phone (704) 945-6843

Other practice location 3

268 Gillman Rd Ste A
Denver, NC 28037-7925
Phone (704) 659-7830

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200715000992 NC Practitioner - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Medical Oncology 8729368121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Medical Oncology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Oncology Specialists PLLCGroup PAC ID 4082739560, 14 clinicians

Practice addresses (Care Compare)

9930 Kincey Ave
Suite 165
Huntersville, NC 28078-6541
Phone (704) 947-5005

Hospital & facility affiliations

  • Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039
  • Duke Health Lake Norman Hospital Hospital, Mooresville, NC, CCN 340129
  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285941NYMDInternal Medicine Physician
2020-02069NCMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Oncology Specialists, PLLC CurrentSince Jul 27, 2020 Accepting new patients
Southern Oncology Specialists, PLLC Hematology & Oncology CurrentSince Jul 27, 2020 Accepting new patients

Locations

10320 Mallard Creek Rd
Ste 100
Charlotte, NC 28262
Phone (704) 547-9500

268 Gillman Rd
Ste A
Denver, NC 28037
Phone (704) 659-7830

10030 Gilead Rd
Ste 290
Huntersville, NC 28078
Phone (704) 947-5005

9930 Kincey Ave
Ste 165
Huntersville, NC 28078
Phone (704) 947-5005

146 Medical Park Rd
Ste 212
Mooresville, NC 28117
Phone (704) 659-7844

1405 Fern Creek Dr
Statesville, NC 28625
Phone (704) 659-7866

Interoperability endpoints

  • Direct secure messaging: ppatel839766@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.

Hospital & facility affiliations 7

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": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1669876447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "877-881-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9930 KINCEY AVE STE 165",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280786541",
            "telephone_number": "704-947-5005",
            "fax_number": "877-881-8455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Medical Park Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "281178529",
            "country_code": "US",
            "telephone_number": "704-659-7850",
            "fax_number": "877-881-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10320 Mallard Creek Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282625204",
            "country_code": "US",
            "telephone_number": "704-945-6843",
            "fax_number": "877-881-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "268 Gillman Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280377925",
            "country_code": "US",
            "telephone_number": "704-659-7830",
            "fax_number": "877-881-8455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PORAS",
        "middle_name": "KAMLESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-22",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "285941",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NC",
            "license": "2020-02069",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NC",
            "license": "2020-02069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.