Pedro Cervantes Fanning, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

2016-01762 Issued in NC

Practice address

13532 Steelecroft Parkway
Charlotte, NC 28278-7545

Phone

(704) 295-3475

Fax

(704) 295-3476

NPI assigned

Oct 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC, SC2 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

Specialty

Ophthalmology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Charlotte Eye Ear Nose and Throat Associates PAGroup PAC ID 0446155451, 181 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

Merit-based Incentive Payment System (MIPS)

Final score

94 of 100Reported as apm

Quality

81.63

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Charlotte Eye Ear Nose & Throat Associates, P.a.

  • Ophthalmology Physician
  • Charlotte, NC
  • NPI 1043287469

  SC

  Medicare reassignment Care Compare group NPD
• Charlotte Eye Ear Nose & Throat Associates, PA

  • Ophthalmology Physician
  • Salisbury, NC
  • NPI 1801217948
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Presbyterian Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1396798591

  Hospital

  Care Compare affiliation
• The Presbyterian Hospital

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1497708838
  Care Compare affiliation
• The Presbyterian Hospital

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1881647204
  Care Compare affiliation
• The Presbyterian Hospital

  • Skilled Nursing Facility
  • Charlotte, NC
  • NPI 1891871901

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1760633812",
    "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": "704-295-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13532 STEELECROFT PARKWAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787545",
            "telephone_number": "704-295-3475",
            "fax_number": "704-295-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTES FANNING",
        "first_name": "PEDRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2016-01762",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036129100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01840923",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7151944",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC2885",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9973753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "19N11",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcervantes5475@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "13532 Steelecroft Parkway",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282787545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Centro Medico Latino, PC
• Centrum Medical Group of North Carolina PLLC
• Christina Marie Cerenzia, DO
• Ariel Marion Cerenzie, OD
• Stephanie Cernuto, PA-C
• Cerwin Clinic of Chiropractic and Sports Medicine, P.a.
• Suzanne G Cescon, SLP
• CFT Counseling and Supervision Services, PLLC
• CH MH Services (NC), LLC
• Michelle Lynn Chachkes, LCSW

• Ophthalmology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.