Active NPI
Martin Lo Sasso III, MD
- Vascular Surgery Physician
- Charlotte, NC
National Provider Identifier
1881252971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 2024-02068
- Practice address
- 1000 Blythe Blvd
Charlotte, NC 28203 - Phone
- (201) 478-0819
- NPI assigned
- Jun 3, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 2024-02068 | NC | Primary |
Addresses
Primary practice location
1000 Blythe Blvd
Charlotte, NC 28203
Mailing address
730 Hawthorne LN Apt 456
Charlotte, NC 28204-2182
Other practice location 1
730 Hawthorne Ln Apt 456
Charlotte, NC 28204-2182
Phone (201) 470-0819
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241216003879 | NC | Order and Referring Only - General Surgery | 4688901457 |
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Rowan University School of Osteopathic Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2490 Riverside Dr
Suite B
Macon, GA 31204-1788
575 1St St
Macon, GA 31201-2893
Hospital & facility affiliations
- Carolinas Medical Center/Behav Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2024-02068 | NC | MD | Vascular Surgery Physician |
Interoperability endpoints
- mlosassoiii2899600@carolinashealthcaresystem.direct-ci.com
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Charlotte, NC
- NPI 1053358945
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1295789907
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1376985135
-
- Children's Rehabilitation Hospital
- Charlotte, NC
- NPI 1699829887
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Charlotte, NC
- NPI 1720029705
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727308800000",
"number": "1881252971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 HAWTHORNE LN APT 456",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BLYTHE BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28203",
"telephone_number": "201-478-0819"
}
],
"practiceLocations": [
{
"address_1": "730 Hawthorne Ln Apt 456",
"address_purpose": "LOCATION",
"city": "Charlotte",
"state": "NC",
"postal_code": "282042182",
"country_code": "US",
"telephone_number": "201-470-0819",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LO SASSO",
"first_name": "MARTIN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-06-03",
"last_updated": "2024-09-26",
"certification_date": "2024-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": "NC",
"license": "2024-02068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.