Individual provider Active NPI

Parinda Kanaiyalal Fruchtman, MD

  • Family Medicine Physician
  • Salisbury, NC
National Provider Identifier
1831277425
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9700247 Issued in NC
Practice address
1406A W Innes St
Salisbury, NC 28144-2502
Phone
(704) 639-0407
Fax
(704) 639-9599
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9700247 NC Primary

Addresses

Primary practice location

1406A W Innes St
Salisbury, NC 28144-2502

Mailing address

105 Willow Rd
Salisbury, NC 28147-7746
Phone (704) 630-0097

Other identifiers 2

IdentifierTypeStateIssuer
890208LMedicaidNC
0208LOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 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
I20100907000589 NC Practitioner - Family Practice 2264556661 Reassigns benefits to 1 organization
I20190719000784 TX Practitioner - Family PracticePractitioner - Pain Management 2264556661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Pain Management
Education
Medical University of South Carolina College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Pain Enterprises LLCGroup PAC ID 8022343615, 3 clinicians

Practice addresses (Care Compare)

10400 N Central Expy
Dallas, TX 75231-2297
Phone (972) 499-4266

1406 A W Innes St
Salisbury, NC 28144-2502
Phone (704) 639-0407

Hospital & facility affiliations

  • Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9700247NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rowan Primary Care, PC CurrentSince Aug 1, 1997 Accepting new patients
Au Monitoring LLC CurrentSince Sep 21, 2016 Accepting new patients
Texas Pain Enterprises LLC CurrentSince May 1, 2019 Accepting new patients

Locations

1406A W Innes St
Salisbury, NC 28144
Phone (704) 639-0407

10400 N Central Expy
Dallas, TX 75231
Phone (972) 884-4400

Interoperability endpoints

  • Direct secure messaging: parinda.fruchtman@3399.securemail.prognocis.com
  • Direct secure messaging: parinda.fruchtman@3436.securemail.prognocis.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831277425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WILLOW RD",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281477746",
            "telephone_number": "704-630-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406A W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442502",
            "telephone_number": "704-639-0407",
            "fax_number": "704-639-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUCHTMAN",
        "first_name": "PARINDA",
        "middle_name": "KANAIYALAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9700247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890208L",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0208L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

Verify at the official NPI Registry.