Individual provider Active NPI

Jay Waldron Patti, MD

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1881685063
Registry record updated Sep 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2008-00201 Issued in NC
Practice address
3623 Latrobe Dr
Suite 216
Charlotte, NC 28211
Phone
(704) 332-1291
Fax
(704) 332-5206
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 219877 MA
Diagnostic Radiology Physician 2085R0202X 2008-00201 NC Primary

Addresses

Primary practice location

3623 Latrobe Dr
Suite 216
Charlotte, NC 28211

Mailing address

PO Box 221249
Charlotte, NC 28222-1249
Phone (704) 332-1291

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
I20080703000170 NC Practitioner - Diagnostic Radiology 7911919543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mecklenburg Radiology Associates PAGroup PAC ID 6800789587, 95 clinicians

Practice addresses (Care Compare)

118 Gateway Blvd
Suite E
Mooresville, NC 28117-6542
Phone (704) 662-8580

1500 Matthews Township Pkwy
Matthews, NC 28105-4656
Phone (704) 384-6750

1616 Myers Park Dr
Charlotte, NC 28207-2670
Phone (704) 332-1291

18524 Rollingdale LN
Davidson, NC 28036-7862
Phone (704) 332-1291

1901 Randolph Rd
Charlotte, NC 28207-1101
Phone (704) 316-1400

19223 Captains Watch Rd
Cornelius, NC 28031-7587
Phone (704) 332-1291

19825 River Falls Dr
Davidson, NC 28036-8869
Phone (704) 332-1291

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 384-4056

2042 Beverly Dr
Charlotte, NC 28207-2602
Phone (704) 332-1291

2224 Yadkin Ave
Charlotte, NC 28205-1864
Phone (704) 332-1291

2608 Flintgrove Rd
Charlotte, NC 28226-5619
Phone (704) 332-1291

2900 Randolph Rd
Charlotte, NC 28211-1021
Phone (704) 384-7140

3115 Springs Farm LN
Charlotte, NC 28226-0911
Phone (704) 332-1291

317 Old Fox TRL
Durham, NC 27713-9454
Phone (704) 332-1291

3623 Latrobe Dr
Suite 216
Charlotte, NC 28211-2117
Phone (704) 332-1291

3734 Columbine Cir
Charlotte, NC 28211-4909
Phone (704) 332-1291

416 Braemar Dr
Matthews, NC 28104-9588
Phone (704) 332-1291

4620 Oglukian Rd
Charlotte, NC 28226-5124
Phone (704) 332-1291

5 Acorn LN
Salisbury, NC 28144-6902
Phone (704) 332-1291

511 Queens Rd
Apt 503
Charlotte, NC 28207-1598
Phone (704) 332-1291

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

653 Concord Rd
Davidson, NC 28036-9033
Phone (704) 332-1291

7005 Camrose Crossing LN
Matthews, NC 28104-6862
Phone (704) 332-1291

9426 Greyson Ridge Dr
Charlotte, NC 28277-0682
Phone (704) 332-1291

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.03 of 100Reported as group
Quality
98.89
Improvement activities
40
Cost
72.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2008-00201NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Enterprises Imaging, LLC Diagnostic Radiology CurrentSince Jun 24, 2026 Accepting new patients
Novant Health Enterprises Imaging, LLC Diagnostic Radiology CurrentSince Jul 21, 2026 Accepting new patients
Mecklenburg Radiology Associates, P.a. Diagnostic Radiology CurrentSince Jul 11, 2008 Accepting new patients
Mecklenburg Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Oct 1, 2022 Accepting new patients
Mecklenburg Diagnostic Imaging LLC Diagnostic Radiology CurrentSince Aug 1, 2009 Accepting new patients

Locations

3623 Latrobe Dr
Ste 216
Charlotte, NC 28211
Phone (704) 926-1827

Organizations & group practices 5

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 8

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599955200000",
    "number": "1881685063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 221249",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282221249",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 LATROBE DR",
            "address_2": "SUITE 216",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28211",
            "telephone_number": "704-332-1291",
            "fax_number": "704-332-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTI",
        "first_name": "JAY",
        "middle_name": "WALDRON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2020-09-13",
        "certification_date": "2020-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "219877",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2008-00201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.