Individual provider Active NPI

Mamta Chandak

  • Family Nurse Practitioner
  • Concord, NC
National Provider Identifier
1699238675
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5011646 Issued in NC
Practice address
101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone
(888) 849-7379
Fax
(855) 857-7333
NPI assigned
Apr 8, 2019
Last updated
Apr 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5011646 NC Primary

Addresses

Primary practice location

101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781

Mailing address

101 Cabarrus Ave E Ste 200
Concord, NC 28025-3781
Phone (888) 849-7379

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
I20190530000768 NC Practitioner - Nurse Practitioner 1850634114 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Eldercare PAGroup PAC ID 0648184705, 236 clinicians
Curana Health of North Carolina PLLCGroup PAC ID 1850774332, 274 clinicians
Geriatric Consultants PLLCGroup PAC ID 5294132387, 56 clinicians

Practice addresses (Care Compare)

5306 NC Hwy 55
Suite 105
Durham, NC 27713-7812
Phone (337) 991-9276

581 NC Hwy 16 S
Taylorsville, NC 28681-9103
Phone (860) 882-7525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5011646NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Eldercare PA CurrentSince Nov 17, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Apr 15, 2022 Accepting new patients
Curana Health of North Carolina PLLC CurrentSince Nov 17, 2025 Accepting new patients
Geriatric Consultants PLLC CurrentSince Jan 10, 2025 Accepting new patients

Locations

5306 NC Highway 55
Ste 105
Durham, NC 27713
Phone (919) 457-1517

6000 Fayetteville Rd
Durham, NC 27713
Phone (919) 544-9021

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

581 NC Highway 16 S
Taylorsville, NC 28681
Phone (828) 632-8146

4692 Brownsboro Rd
Winston Salem, NC 27106
Phone (336) 251-1114

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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 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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1699238675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253781",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CABARRUS AVE E STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280253781",
            "telephone_number": "888-849-7379",
            "fax_number": "855-857-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDAK",
        "first_name": "MAMTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5011646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.