Individual provider Active NPI

Pavan Isanaka, M.D.

  • Interventional Cardiology Physician
  • Gastonia, NC
National Provider Identifier
1932562881
Registry record updated May 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
2023-01291 Issued in NC
Practice address
2555 Court Dr Ste 200
Gastonia, NC 28054-2178
Phone
(703) 587-5715
NPI assigned
Mar 29, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101267290 VA
Student in an Organized Health Care Education/Training Program 390200000X WY
Interventional Cardiology Physician 207RI0011X 2023-01291 NC Primary

Addresses

Primary practice location

2555 Court Dr Ste 200
Gastonia, NC 28054-2178

Mailing address

2555 Court Dr Ste 200
Gastonia, NC 28054-2178
Phone (703) 587-5715

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
I20230919002075 NC Practitioner - Cardiovascular Disease (Cardiology) 6800181256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2015
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)

2555 Court Dr
Suite 200
Gastonia, NC 28054-2178
Phone (704) 867-2141

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Caromont Medical Group Inc Internal Medicine Current Accepting new patients
Caromont Medical Group Inc CurrentSince Aug 11, 2023 Accepting new patients
Caromont Medical Group Inc Interventional Cardiology CurrentSince Aug 11, 2023 Accepting new patients
Caromont Medical Group Inc Past Accepting new patients

Locations

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

2555 Court Dr
Ste 200
Gastonia, NC 28054
Phone (704) 671-7670

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": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1932562881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542178",
            "telephone_number": "703-587-5715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 COURT DR STE 200",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542178",
            "telephone_number": "703-587-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISANAKA",
        "first_name": "PAVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101267290",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WY",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "2023-01291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.