Individual provider Active NPI

Idan Cudykier, M.D

  • Emergency Medicine Physician
  • Charlotte, NC
National Provider Identifier
1831455229
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2015-00361 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 10, 2012
Last updated
Oct 11, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 2015-00361 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

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
I20150910002221 NC Practitioner - Emergency Medicine 4880901685 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Miami, LM Miller School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians
Mid-Atlantic Emergency Medical Associates PLLCGroup PAC ID 4880686823, 100 clinicians

Practice addresses (Care Compare)

3536 Mt Holly Huntersville Rd
Charlotte, NC 28216-8644
Phone (336) 716-2255

612 Mocksville Ave
Salisbury, NC 28144-2732
Phone (704) 210-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Emergency Medical Associates, PLLC Emergency Medicine CurrentSince Nov 1, 2021 Accepting new patients
Wake Forest Emergency Providers CurrentSince Jan 13, 2024 Accepting new patients
Mema SC LLC Emergency Medicine CurrentSince Oct 13, 2024 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Emergency Medicine CurrentSince May 1, 2016 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

10628 Park Rd
Charlotte, NC 28210
Phone (704) 543-2000

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

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

3536 Mt Holly Huntersville Rd
Charlotte, NC 28216
Phone (704) 801-6500

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

6965 Fairview Rd
Charlotte, NC 28210
Phone (704) 631-1300

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

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

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

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, 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": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1831455229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "CUDYKIER",
        "first_name": "IDAN",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2015-00361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.