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CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
NPI 1396930442
Ophthalmology in Pineville, NC

Active since September 12, 2007CLIA 34D0900427 · Waiver
10405 CENTRUM PKWY, PINEVILLE, NC 28134(704) 295-3650(704) 295-3666 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Apr 8, 2025, Apr 3, 2025, Apr 28, 2022 (3 updates tracked since 2022).

About Charlotte Eye Ear Nose & Throat Associates, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA (NPI 1396930442) is a healthcare organization registered as an ophthalmology in Pineville, North Carolina and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through April 26, 2027 and lists Jag S Gill, Ceo, as its authorized official.

NPPES Registry Identity

NPI1396930442
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameCHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Location Address10405 CENTRUM PKWYPineville, NC 28134-8825
Mailing Address6035 Fairview RdCharlotte, NC 28210-3256 · (704) 295-3000 · Fax (704) 838-8494
Phone(704) 295-3650
Fax(704) 295-3666
Organization SubpartNo
Authorized OfficialJag S GillCeo · (704) 295-3000
Enumeration DateSeptember 12, 2007
Last NPPES UpdateApril 8, 20253 updates tracked since enumeration
NPPES CertifiedApril 8, 2025
✔ NPI 1396930442 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOtolaryngologyTaxonomy 207Y00000X
10405 CENTRUM PKWY, Pineville, NC 28134
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Charlotte Eye Ear Nose & Throat Associates, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateNorth CarolinaEnrollment IDO20031203000519Non-DME Part B · Clinic/Group PracticeDue dateJanuary 31, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

181

Medicare enrollment records show 181 clinicians reassign Medicare billing to Charlotte Eye Ear Nose & Throat Associates, PA, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 99 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Otolaryngology61
Qualified Audiologist54
Ophthalmology46
Qualified Speech Language Pathologist11
Optometry5
Nurse Practitioner3
Pediatric Medicine1

Nearest to this location (20)

See all 181
Alexandra Pietraszkiewicz, MD
Ophthalmology
NPI 1952964124
10405 CENTRUM PKWY
Pineville, NC 28134
(704) 295-3650
✔ PECOS✔ Accepts MedicareSame address
Lee Wiley
Ophthalmology
NPI 1518351493
10405 CENTRUM PKWY
Pineville, NC 28134
(704) 295-3650
✔ PECOS✔ Accepts MedicareSame address
Marilyn Collins, MD
Ophthalmology
NPI 1083291132
10405 CENTRUM PKWY
Pineville, NC 28134
(704) 295-3650
✔ PECOS✔ Accepts MedicareSame address
Stephen Clyne, M.D.
Otolaryngology
NPI 1427026210
10512 PARK RD SUITE 200
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare0.3 mi
Melinda Bean, MS CCCA
Qualified Audiologist
NPI 1801062997
14610 CREEK WATCH PL APT 3004
Charlotte, NC 28277
(904) 521-5054
4.4 mi
Nnana Amakiri, MD
Ophthalmology
NPI 1538747761
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Katie Anderson, AUD
Qualified Audiologist
NPI 1265102875
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
4.6 mi
Steven Aziz
Otolaryngology
NPI 1760943443
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Greer Bailey, AUD
Qualified Audiologist
NPI 1710440086
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ Accepts Medicare4.6 mi
Darrin Bann, MD, PHD
Otolaryngology
NPI 1437544152
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Duncan Berry, MD
Ophthalmology
NPI 1326488560
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Sydney Bodnar, SLP
Qualified Speech Language Pathologist
NPI 1720898927
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
4.6 mi
Justin Brown, M.D.
Ophthalmology
NPI 1548228026
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Tegan Demarcus
Qualified Speech Language Pathologist
NPI 1184346421
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
4.6 mi
Lukas Dumberger, MD
Otolaryngology
NPI 1013404532
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 838-8493
✔ PECOS✔ Accepts Medicare4.6 mi
Adrian Elfersy, M.D.
Ophthalmology
NPI 1457670606
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Terri Gerlach, PHD, CCC-SLP
Qualified Speech Language Pathologist
NPI 1063746253
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ Accepts Medicare4.6 mi
Lea Heuer, OD
Optometry
NPI 1982405064
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS4.6 mi
Norman Melton, OD
Optometry
NPI 1013961069
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS✔ Accepts Medicare4.6 mi
Tyler Thomas, OD
Optometry
NPI 1699668038
6035 FAIRVIEW RD
Charlotte, NC 28210
(704) 295-3000
✔ PECOS4.6 mi
See all 181 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D0900427

Charlotte Eye Ear Nose & Throat Associates PA · Pineville, NC
Active · expires Apr 26, 2027
CLIA Number34D0900427
Laboratory TypePhysician Office
Certificate Effective DateApril 27, 2025
Certificate Expiration DateApril 26, 2027
Laboratory DirectorStephen B. Clyne
Laboratory Phone(704) 358-4200
Laboratory LocationCharlotte Eye Ear Nose & Throat Associates PA1045 Centrum Parkway, Pineville, NC 28134
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charlotte Eye Ear Nose & Throat Associates, PA's NPI number?

The NPI number for Charlotte Eye Ear Nose & Throat Associates, PA is 1396930442. It was assigned to this organization in the NPPES registry on September 12, 2007.

Where is Charlotte Eye Ear Nose & Throat Associates, PA located?

Charlotte Eye Ear Nose & Throat Associates, PA is located at 10405 Centrum Pkwy, Pineville, NC 28134. The listed phone number is (704) 295-3650.

What is Charlotte Eye Ear Nose & Throat Associates, PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Charlotte Eye Ear Nose & Throat Associates, PA enrolled in Medicare?

Yes. Charlotte Eye Ear Nose & Throat Associates, PA is registered in the Medicare PECOS enrollment system.

When is Charlotte Eye Ear Nose & Throat Associates, PA's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (North Carolina, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Charlotte Eye Ear Nose & Throat Associates, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 181 clinicians in 7 Medicare specialties reassign their Medicare billing to Charlotte Eye Ear Nose & Throat Associates, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Otolaryngology (61), Qualified Audiologist (54) and Ophthalmology (46). Of these, 3 practice at this address and 99 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Charlotte Eye Ear Nose & Throat Associates, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D0900427) is associated with this NPI, valid through April 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Charlotte Eye Ear Nose & Throat Associates, PA was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.