Individual provider Active NPI

Steve Eleftheris Vacalis, D.O.

  • Family Medicine Physician
  • Gastonia, NC
National Provider Identifier
1871580399
Registry record updated Jul 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9901066 Issued in NC
Practice address
2711 X Ray Dr
Gastonia, NC 28054-7491
Phone
(704) 834-2420
Fax
(704) 834-2426
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2011

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 9901066 NC Primary

Addresses

Primary practice location

2711 X Ray Dr
Gastonia, NC 28054-7491

Mailing address

2711 X Ray Dr
Gastonia, NC 28054-7491
Phone (704) 834-2420

Other identifiers 2

IdentifierTypeStateIssuer
891220GMedicaidNC
N01067MedicaidSC

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
I20080903000475 NC Practitioner - Family Practice 1658447347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caromont Medical Group IncGroup PAC ID 3577476258, 425 clinicians

Practice addresses (Care Compare)

2525 Court Dr
Gastonia, NC 28054-2140
Phone (704) 834-2450

2711 X Ray Dr
Suite 3701
Gastonia, NC 28054-7491
Phone (980) 384-9600

2711 Xray Dr
Suite 3106
Gastonia, NC 28054-7491
Phone (704) 834-2420

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9901066NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Family Medicine Current Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince Sep 7, 1999 Accepting new patients
Caromont Medical Group Inc Family Medicine CurrentSince Sep 7, 1999 Accepting new patients
Caromont Medical Group Inc Family Medicine Past Accepting new patients

Locations

660 Summit Crossing Pl
Ste 301
Gastonia, NC 28054
Phone (704) 854-8799

2711 X Ray Dr
Ste 3106
Gastonia, NC 28054
Phone (704) 834-2420

2711 X Ray Dr
Gastonia, NC 28054
Phone (704) 834-2420

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

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 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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310947200000",
    "number": "1871580399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547491",
            "telephone_number": "704-834-2420",
            "fax_number": "704-834-2426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 X RAY DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547491",
            "telephone_number": "704-834-2420",
            "fax_number": "704-834-2426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACALIS",
        "first_name": "STEVE",
        "middle_name": "ELEFTHERIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2011-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9901066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891220G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01067",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.