Individual provider Active NPI

Perry Lester Bartelt, MD

  • Family Medicine Physician
  • Statesville, NC
National Provider Identifier
1760461529
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30995 Issued in NC
Practice address
276 Old Mocksville Rd
Suite 400
Statesville, NC 28625-1949
Phone
(704) 878-6592
NPI assigned
Jan 11, 2006
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30995 NC Primary

Addresses

Primary practice location

276 Old Mocksville Rd
Suite 400
Statesville, NC 28625-1949

Mailing address

650 Signal Hill Drive Ext
PO Box 1845
Statesville, NC 28625-4353
Phone (704) 873-4277

Other identifiers 1

IdentifierTypeStateIssuer
6913595MedicaidNC

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
I20050822000149 NC Practitioner - Family Practice 6709816069

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

276 Old Mocksville Rd
Suite 400
Statesville, NC 28625-1949

650 Signal Hill Dr Ext
Statesville, NC 28625-4353

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30995NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Emergency Medical Associates, PLLC Past Accepting new patients

Organizations & group practices 1

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 2

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1760461529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SIGNAL HILL DRIVE EXT",
            "address_2": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-873-4277",
            "fax_number": "704-873-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 OLD MOCKSVILLE RD",
            "address_2": "SUITE 400",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251949",
            "telephone_number": "704-878-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTELT",
        "first_name": "PERRY",
        "middle_name": "LESTER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "30995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6913595",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.