Individual provider Active NPI

Ala Stanford

  • Surgery Physician
  • Charlotte, NC
National Provider Identifier
1750394037
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2014-00902 Issued in NC
Practice address
1025 Morehead Medical Dr
Suite 275
Charlotte, NC 28204-2963
Phone
(704) 403-2662
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 2014-00902 NC Primary

Addresses

Primary practice location

1025 Morehead Medical Dr
Suite 275
Charlotte, NC 28204-2963

Mailing address

1025 Morehead Medical Dr
Charlotte, NC 28204-2963

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061101000385 PA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology)Practitioner - Surgical OncologyPractitioner - Pediatric MedicinePractitioner - Thoracic Surgery 8729085949
I20150805007011 NJ Practitioner - General SurgeryPractitioner - Surgical OncologyPractitioner - Pediatric MedicinePractitioner - Colorectal Surgery (Proctology)Practitioner - Thoracic Surgery 8729085949 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2014-00902NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stanford Pediatric Surgery, LLC Surgery Current Accepting new patients
Saint Peter's University Hospital CurrentSince Oct 14, 2017 Accepting new patients
Cooper Surgical Associates, PA CurrentSince Jul 1, 2015 Accepting new patients
Saint Peter's University Hospital Current Accepting new patients
Cooper University Trauma Physicians, PC CurrentSince Jul 1, 2015 Accepting new patients
Dr Ala Stanford Center for Health Equity Past Accepting new patients

Locations

3 Cooper Plz
Rm 411
Camden, NJ 08103
Phone (856) 342-2270

3 Cooper Plz
Rm 200
Camden, NJ 08103
Phone (609) 342-2001

1 Cooper Plz
Camden, NJ 08103
Phone (856) 342-2425

254 Easton Ave
New Brunswick, NJ 08901
Phone (732) 565-5453

123 How Ln
New Brunswick, NJ 08901
Phone (732) 448-1000

419 Johnson St
Jenkintown, PA 19046
Phone (215) 277-5450

Interoperability endpoints

  • Direct secure messaging: dr.alastanford@spsl-pa.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/8568/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1750394037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MOREHEAD MEDICAL DR",
            "address_2": "SUITE 275",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042963",
            "telephone_number": "704-403-2662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "ALA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2014-00902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.