NPIMap

Individual provider Active NPI

Ipe George Kalathoor, MD

  • Internal Medicine Physician
  • Concord, NC
National Provider Identifier
1992024087
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2013-01637 Issued in NC
Practice address
1085 NE Gateway CT NE
Ste 200
Concord, NC 28025-2406
Phone
(704) 403-8650
NPI assigned
May 28, 2010
Last updated
Jul 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2013-01637 NC Primary

Addresses

Primary practice location

1085 NE Gateway CT NE
Ste 200
Concord, NC 28025-2406

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5427 Nc Highway 49 S
Ste 102
Harrisburg, NC 28075-7408
Phone (704) 454-7360

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ikalathoor136833@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

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
I20170124002620 NC Practitioner - Internal Medicine 7517098726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

1085 NE Gateway CT NE
Suite 200
Concord, NC 28025-2412
Phone (704) 403-8650

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2013-01637NCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Internal Medicine CurrentSince Oct 30, 2023 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 30, 2023 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine CurrentSince Oct 30, 2023 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Internal Medicine PastSince Dec 1, 2019 Accepting new patients
Carolinas Medical Center-Northeast Internal Medicine PastSince Dec 1, 2019 Accepting new patients
Carolinas Physicians Network, Inc Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

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

1085 NE Gateway Ct NE
Ste 200
Concord, NC 28025
Phone (704) 260-8650

5427 NC Highway 49 S
Ste 102
Harrisburg, NC 28075
Phone (704) 454-7360

Interoperability endpoints

  • Direct secure messaging: ikalathoor136833@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 8

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1992024087",
    "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": "1085 NE GATEWAY CT NE",
            "address_2": "STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252406",
            "telephone_number": "704-403-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5427 Nc Highway 49 S",
            "address_2": "Ste 102",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "NC",
            "postal_code": "280757408",
            "country_code": "US",
            "telephone_number": "704-454-7360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALATHOOR",
        "first_name": "IPE",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-07-15",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2013-01637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ikalathoor136833@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1085 NE Gateway Ct NE",
            "address_2": "Ste 200",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252406",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.