NPIMap

Individual provider Active NPI

Michael Roden, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1669980314
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021749 Issued in NY
Practice address
225 Baldwin Ave
Charlotte, NC 28204-3109
Phone
(704) 376-1605
NPI assigned
Jan 16, 2018
Last updated
Jan 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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 021749 NY Primary

Addresses

Primary practice location

225 Baldwin Ave
Charlotte, NC 28204-3109

Mailing address

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.roden.p1@direct.cnsa.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC, SC3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190503000745 NY Practitioner - Physician Assistant 5395087712 Reassigns benefits to 2 organizations
I20210629003311 NC Practitioner - Physician Assistant 5395087712 Reassigns benefits to 2 organizations
I20210816000368 SC Practitioner - Physician Assistant 5395087712 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Neurosurgery and Spine Associates PAGroup PAC ID 7214833375, 104 clinicians

Practice addresses (Care Compare)

110 Lake Concord Rd NE
Concord, NC 28025-2918
Phone (704) 792-2672

225 Baldwin Ave
Charlotte, NC 28204-3109
Phone (704) 376-1605

937 Riverwalk Pkwy
Rock Hill, SC 29730-0178
Phone (803) 325-1618

937 Riverwalk Pkwy
Suite 101
Rock Hill, SC 29730-0179
Phone (803) 325-1618

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4040SCMDChiropractor
021749NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Carolina Neurosurgery & Spine Associates PA CurrentSince Sep 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2020 Accepting new patients
Carolina Neurosurgery & Spine Associates PA CurrentSince Sep 1, 2021 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2020 Accepting new patients
Atrium Health Neurospine Network LLC CurrentSince Oct 1, 2025 Accepting new patients
Carolina Neurosurgery, PA Past Accepting new patients

Locations

14135 Ballantyne Corporate Pl
Ste 225
Charlotte, NC 28277
Phone (704) 316-2930

225 Baldwin Ave
Charlotte, NC 28204
Phone (704) 376-1605

110 Lake Concord Rd NE
Concord, NC 28025
Phone (704) 792-2672

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

1010 N Broadway
Yonkers, NY 10701
Phone (914) 968-3535

937 Riverwalk Pkwy
Rock Hill, SC 29730
Phone (803) 325-1618

937 Riverwalk Pkwy
Ste 101
Rock Hill, SC 29730
Phone (800) 344-6716

Interoperability endpoints

  • FHIR API: https://epicproxy.et0905.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: michael.roden.p1@direct.cnsa.nextgenshare.com
  • Direct secure messaging: mroden690930@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1669980314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BALDWIN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282043109",
            "telephone_number": "704-376-1605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-16",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.roden.p1@direct.cnsa.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "225 Baldwin Ave",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282043109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.