NPIMap

Individual provider Active NPI

Ilya Alishayev, DO

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1972824902
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2016-00823 Issued in NC
Practice address
101 E WT Harris Blvd
Ste 5002
Charlotte, NC 28262-3485
Phone
(704) 801-7310
NPI assigned
Jun 14, 2010
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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 2016-00823 NC Primary

Addresses

Primary practice location

101 E WT Harris Blvd
Ste 5002
Charlotte, NC 28262-3485

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

101 E W T Harris Blvd
Ste 5401
Charlotte, NC 28262-3485
Phone (704) 863-9700

Other practice location 2

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277-3372
Phone (704) 667-2650

Other practice location 3

705 Griffith St
Ste 100
Davidson, NC 28036-9304
Phone (704) 801-7350

Other practice location 4

1585 Forney Creek Pkwy
Denver, NC 28037-9514
Phone (704) 801-7320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810001487 NC Practitioner - Family Practice 9739337882 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proactive Therapy of North Carolina IncGroup PAC ID 6305753120, shared by 5 NPIs, 540 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians
Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

201 McCullough Dr
Charlotte, NC 28262-3577
Phone (704) 547-1129

3367 N NC 16 Business Hwy
Denver, NC 28037-8265
Phone (419) 221-6717

409 Olin Way
Suite 1200
Denver, NC 28037-9250
Phone (704) 801-7320

4525 Cameron Valley Pkwy
Suite 4100D
Charlotte, NC 28211-4369
Phone (980) 402-1800

7482 Waterside Crossing Blvd
Denver, NC 28037-3006
Phone (704) 827-0598

9611 Sherrill Estates Rd
Suite B
Huntersville, NC 28078-6504
Phone (704) 801-1150

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince May 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Family Medicine CurrentSince May 1, 2020 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 1, 2020 Accepting new patients
Atrium Health North Market Network LLC Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Carolinas Physicians Network Inc Family Medicine Past Accepting new patients

Locations

101 E W T Harris Blvd
Ste 5401
Charlotte, NC 28262
Phone (704) 863-1400

101 E Wt Harris Blvd
Ste 1110
Charlotte, NC 28262
Phone (704) 339-1073

101 E Wt Harris Blvd
Ste 5002
Charlotte, NC 28262
Phone (704) 548-8724

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

705 Griffith St
Ste 100
Davidson, NC 28036
Phone (704) 801-7900

1585 Forney Creek Pkwy
Denver, NC 28037
Phone (704) 801-1760

409 Olin Way
Ste 1200
Denver, NC 28037
Phone (704) 801-7320

16455 Statesville Rd
Ste 360
Huntersville, NC 28078
Phone (704) 801-3300

9816 Sam Furr Rd
Ste 101
Huntersville, NC 28078
Phone (423) 343-7020

123 Professional Park Dr
Ste 200
Mooresville, NC 28117
Phone (423) 343-7016

Interoperability endpoints

  • Direct secure messaging: ialishayev411869@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 7

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 10

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": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1972824902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WT HARRIS BLVD",
            "address_2": "STE 5002",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623485",
            "telephone_number": "704-801-7310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 5401",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-9700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14214 Ballantyne Lake Rd",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282773372",
            "country_code": "US",
            "telephone_number": "704-667-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Griffith St",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Davidson",
            "state": "NC",
            "postal_code": "280369304",
            "country_code": "US",
            "telephone_number": "704-801-7350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1585 Forney Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280379514",
            "country_code": "US",
            "telephone_number": "704-801-7320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALISHAYEV",
        "first_name": "ILYA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2016-00823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.