Ilya Alishayev, DO
Individual provider Active NPI Family Medicine Physician · Charlotte, NC
NPI 1972824902 · NPPES record last updated Sep 25, 2020
Key facts
- NPI
- 1972824902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2016-00823 (NC)
- Practice address
- 101 E WT Harris Blvd
Ste 5002
Charlotte, NC 28262-3485 - Phone
- (704) 801-7310
- NPI assigned
- Jun 14, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 10
Medicare Care Compare profile
- 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 Inc
Carolina Physical Therapy Associates LLC
Atrium Health North Market Network LLC
Select Physical Therapy Holdings Inc
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
- Centerwell Home Health
- Atrium Health at Home Lincoln
- Carolinas Medical Center/Behav Health
- Atrium Health Lincoln
- Atrium Health Cleveland
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160810001487 | NC | Practitioner - Family Practice | 9739337882 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016-00823 | NC | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrium Health North Market Network LLC | Family Medicine | Current |
Accepting new patients |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current | Accepting new patients | |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Family Medicine | Current |
Accepting new patients |
| Carolinas Physicians Network Inc | Current |
Accepting new patients | |
| Carolinas Physicians Network Inc | Family Medicine | Past | Accepting new patients |
Locations
101 E Wt Harris Blvd
Ste 5401
Charlotte, NC 28262
Phone (704) 863-1400
101 E Wt Harris Blvd
Ste 5002
Charlotte, NC 28262
Phone (704) 548-8724
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
14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650
101 E Wt Harris Blvd
Ste 1110
Charlotte, NC 28262
Phone (704) 339-1073
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
9816 Sam Furr Rd
Ste 101
Huntersville, NC 28078
Phone (423) 343-7020
16455 Statesville Rd
Ste 360
Huntersville, NC 28078
Phone (704) 801-3300
123 Professional Park Dr
Ste 200
Mooresville, NC 28117
Phone (423) 343-7016
Interoperability endpoints
- ialishayev411869@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2016-00823 | NC | Yes |
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
Other providers in Charlotte, NC
- Aligned Behavioral Health
- Angela Fatana Alimi
- Nazila Alimohammadi
- Alis Behavioral Health of North Carolina LLC
- Alisaha'S Home Center
- Alison McKensie PLLC
- Zhala Aliyeva
- James Alkema
- Maram Alkhatib
- Jordan-Marie Alkins
All providers in Charlotte, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.