Individual provider Active NPI

Alicia Mae Bartek, MD

  • Pediatrics Physician
  • Charlotte, NC
National Provider Identifier
1740785468
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
238455 Issued in NC
Practice address
8110 Healthcare Loop
Charlotte, NC 28215-7069
Phone
(704) 316-2312
Fax
(704) 316-2316
NPI assigned
Mar 26, 2018
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 238455 NC Primary

Addresses

Primary practice location

8110 Healthcare Loop
Charlotte, NC 28215-7069

Mailing address

PO Box 60447
Charlotte, NC 28260-0447

Other practice location 1

1000 Blythe Blvd Fl 4
Charlotte, NC 28203
Phone (704) 381-6800

Other names 1

  • Dr. Alicia Mae Rose Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abartek891683@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
I20210727001331 NC Practitioner - Pediatric Medicine 2961759709 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
238455NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC Current Accepting new patients
Novant Health Medical Group, LLC CurrentSince Jul 2, 2021 Accepting new patients
Novant Health Medical Group, LLC Pediatrics CurrentSince Jul 2, 2021 Accepting new patients
Novant Medical Group, Inc. Past Accepting new patients

Locations

8110 Healthcare Loop
Charlotte, NC 28215
Phone (704) 316-2312

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

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

Interoperability endpoints

  • Direct secure messaging: abartek891683@direct.novanthealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1740785468",
    "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": "8110 HEALTHCARE LOOP",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282157069",
            "telephone_number": "704-316-2312",
            "fax_number": "704-316-2316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd Fl 4",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28203",
            "country_code": "US",
            "telephone_number": "704-381-6800",
            "fax_number": "704-381-6841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTEK",
        "first_name": "ALICIA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "238455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abartek891683@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "8110 Healthcare Loop",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282157069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "ROSE",
            "middle_name": "MAE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.