NPIMap

Individual provider Active NPI

Jonas John Varaly, DO

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1790806826
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2012-01105 Issued in NC
Practice address
501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone
(704) 377-2424
Fax
(704) 377-2687
NPI assigned
Apr 3, 2007
Last updated
Aug 13, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1623 SC
Emergency Medicine Physician 207P00000X 2012-01105 NC Primary

Addresses

Primary practice location

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035

Mailing address

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Other identifiers 3

IdentifierTypeStateIssuer
1790806826MedicaidNC
NC1693MedicaidSC
1790806826OtherNCNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000817 NC Practitioner - Emergency Medicine 5799881199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Emergency Medical Associates PLLCGroup PAC ID 4880686823, 100 clinicians

Practice addresses (Care Compare)

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.97 of 100Reported as group
Quality
79.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1623SCMDGeneral Practice Dentistry
2012-01105NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Emergency Medical Associates, PLLC Emergency Medicine CurrentSince Nov 1, 2015 Accepting new patients
Mema SC LLC Emergency Medicine CurrentSince Oct 13, 2024 Accepting new patients
Centre Emergency Medical Associates, PC. Emergency Medicine Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211
Phone (704) 319-5821

1500 Matthews Township Pkwy
Matthews, NC 28105
Phone (704) 384-6500

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

Organizations & group practices 3

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 7

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1790806826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARALY",
        "first_name": "JONAS",
        "middle_name": "JOHN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "1623",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2012-01105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790806826",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC1693",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "1790806826",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.