Individual provider Active NPI

Claire Engel Holmquist, PA

  • Medical Physician Assistant
  • Charlotte, NC
National Provider Identifier
1669945259
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0010-08705 Issued in NC
Practice address
11301 Golf Links Dr N Ste 203
Charlotte, NC 28277-8014
Phone
(704) 321-3376
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 0010-08705 NC
Medical Physician Assistant 363AM0700X 0010-08705 NC Primary

Addresses

Primary practice location

11301 Golf Links Dr N Ste 203
Charlotte, NC 28277-8014

Mailing address

11301 Golf Links Dr N Ste 203
Charlotte, NC 28277-8014
Phone (704) 321-3376

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190213000192 NC Practitioner - Physician Assistant 2961740204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Darst Dermatology PCGroup PAC ID 1850441908, 5 clinicians

Practice addresses (Care Compare)

11301 Golf Links Dr N
Suite 203
Charlotte, NC 28277-8014
Phone (704) 321-3376

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-08705NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Dermatopathology, Inc Past Accepting new patients

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1669945259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11301 GOLF LINKS DR N STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778014",
            "telephone_number": "704-321-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 GOLF LINKS DR N STE 203",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778014",
            "telephone_number": "704-321-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMQUIST",
        "first_name": "CLAIRE",
        "middle_name": "ENGEL",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "0010-08705",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-08705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.