Individual provider Active NPI

Todd R Reulbach, M.D.

  • Otolaryngology Physician
  • Huntersville, NC
National Provider Identifier
1730158858
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
9701561 Issued in NC
Practice address
10305 Hamptons Park Drive
Suite 201
Huntersville, NC 28078-7217
Phone
(704) 295-3600
Fax
(704) 892-3181
NPI assigned
Mar 14, 2006
Last updated
Apr 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 9701561 NC Primary

Addresses

Primary practice location

10305 Hamptons Park Drive
Suite 201
Huntersville, NC 28078-7217

Mailing address

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Other identifiers 6

IdentifierTypeStateIssuer
000000297877OtherSCUNISON HEALTH PLAN OF SC
134K5OtherNCBCBS
20097009OtherSCSELECT HEALTH OF SC
N01561MedicaidSC
P00026764OtherNCRAILROAD MEDICARE
89134K5MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address treulbach5779@direct.ceenta.com

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
I20040519000038 NC Practitioner - Otolaryngology 6305837493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wake Forest University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10405 Centrum Pkwy
Pineville, NC 28134-8825
Phone (704) 295-3650

144 Fountain PL
Mooresville, NC 28117-0162
Phone (704) 658-0595

2325 W Arbors Dr
Suite 201
Charlotte, NC 28262-2664
Phone (704) 295-3500

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701561NCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Eye Ear Nose & Throat Associates, P.a. Otolaryngology CurrentSince Jun 30, 2003 Accepting new patients
Charlotte Eye Ear Nose & Throat Associates, PA CurrentSince Jun 30, 2003 Accepting new patients

Locations

6035 Fairview Rd
Charlotte, NC 28210
Phone (336) 718-2078

645 Amalia St NE
Concord, NC 28025
Phone (704) 295-3255

10305 Hamptons Park Dr
Ste 201
Huntersville, NC 28078
Phone (704) 295-3600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1730158858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 FAIRVIEW RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103256",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10305 HAMPTONS PARK DRIVE",
            "address_2": "SUITE 201",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787217",
            "telephone_number": "704-295-3600",
            "fax_number": "704-892-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REULBACH",
        "first_name": "TODD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "9701561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN OF SC",
            "identifier": "000000297877",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "134K5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH OF SC",
            "identifier": "20097009",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01561",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00026764",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134K5",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "treulbach5779@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "10305 Hamptons Park Drive",
            "address_2": "Suite 201",
            "city": "Huntersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280787217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

Verify at the official NPI Registry.