Individual provider Active NPI

Ilan D Avin, MD

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1710999628
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2012-02326 Issued in NC
Practice address
2104 Randolph Rd
Charlotte, NC 28207-1522
Phone
(704) 377-3900
Fax
(704) 377-1244
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2012-02326 NC Primary

Addresses

Primary practice location

2104 Randolph Rd
Charlotte, NC 28207-1522

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iavin45353@direct.novanthealth.org

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
I20130327000399 NC Practitioner - General SurgeryPractitioner - Surgical Oncology 9537285853 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
Virginia Commonwealth University, School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Medical Group, LLCGroup PAC ID 1153234893, 2,413 clinicians

Practice addresses (Care Compare)

19830 Zion Ave
Cornelius, NC 28031-8495
Phone (704) 377-3900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)26
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012-02326NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Medical Group Inc Surgery CurrentSince Apr 1, 2013 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2020 Accepting new patients
The Presbyterian Hospital CurrentSince Oct 4, 2020 Accepting new patients
The Presbyterian Hospital Current Accepting new patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Apr 1, 2013 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients

Locations

330 Billingsley Rd
Ste 202
Charlotte, NC 28211
Phone (704) 316-2350

2104 Randolph Rd
Charlotte, NC 28207
Phone (704) 344-3900

335 N Caswell Rd
Charlotte, NC 28204
Phone (704) 384-7390

6324 Fairview Rd
Ste 330
Charlotte, NC 28210
Phone (704) 316-1950

125 Queens Rd
Charlotte, NC 28204
Phone (980) 302-6380

125 Queens Rd
Ste 430
Charlotte, NC 28204
Phone (980) 302-6300

19830 Zion Ave
Cornelius, NC 28031
Phone (704) 384-1782

9735 Kincey Ave
Ste 205
Huntersville, NC 28078
Phone (704) 316-5523

1450 Matthews Township Pkwy
Ste 230
Matthews, NC 28105
Phone (704) 384-8615

1450 Matthews Township Pkwy
Ste 320
Matthews, NC 28105
Phone (704) 377-3900

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Organizations & group practices 7

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 5

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1710999628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071522",
            "telephone_number": "704-377-3900",
            "fax_number": "704-377-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVIN",
        "first_name": "ILAN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2012-02326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iavin45353@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "2104 Randolph Rd",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.