JUSTIN S SWARTZ MD
NPI 1497930499
Internal Medicine - Pulmonary Disease in Charlotte, NC

Active since January 08, 2008PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
1237 HARDING PL, STE 3200, CHARLOTTE, NC 28204(704) 355-5375 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 16, 2024, May 8, 2023, Mar 10, 2023 and 56 more (59 updates tracked since 2016).

About Justin S Swartz Md NPPES

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

JUSTIN S SWARTZ MD (NPI 1497930499) is an individual pulmonary disease provider in Charlotte, North Carolina, licensed in North Carolina (2008-00446) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, is affiliated with Atrium Health Cleveland, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1497930499
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameJUSTIN S SWARTZCredential: MD
Location Address1237 HARDING PL, STE 3200Charlotte, NC 28204
Mailing AddressPo Box 19305Charlotte, NC 28219-9305
Sole ProprietorNo
Medical School CMSUniversity Of South Carolina School Of MedicineGraduated 2001
Enumeration DateJanuary 8, 2008
Last NPPES UpdateJuly 16, 202459 updates tracked since enumeration
NPI 1497930499 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
License Licensed in NC · 2008-00446
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 2008-00446 (NC)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 2008-00446 (NC)
1237 HARDING PL, Charlotte, NC 28204

Secondary Practice Locations 2

Location 110650 Park Rd, Ste 300Charlotte, NC 28210-8538 · Phone (704) 667-3925
Location 21350 S Kings DrCharlotte, NC 28207-2134 · Phone (704) 446-4490

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Justin S Swartz Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294708863
PECOS Enrollment IDI20080731000431
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
114 services82 patients
Test to examine how well the lungs exchange gases 94729
This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.
107 services97 patients
Test to measure expiratory airflow and volume 94010
This test, known as spirometry, assesses how well your lungs work. It measures how much air you can inhale, how much you can exhale and how quickly you can exhale. It's non-invasive and helps diagnose conditions like asthma or COPD.
104 services94 patients
Test to determine lung volumes using sensors 94726
This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.
98 services91 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
91 services54 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
49 services42 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Atrium Health Cleveland

Acute Care Hospitals · Shelby, NC
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340021
Location201 E Grover StShelby, NC 28150 · Cleveland County
Emergency services Birthing friendly

Atrium Health Pineville

Acute Care Hospitals · Charlotte, NC
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340098
Location10628 Park RdCharlotte, NC 28210 · Mecklenburg County
Emergency services Birthing friendly

Carolinas Medical Center/Behav Health

Acute Care Hospitals · Charlotte, NC
2/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340113
Location1000 Blythe BlvdCharlotte, NC 28203 · Mecklenburg County
Emergency services Birthing friendly

Atrium Health Union

Acute Care Hospitals · Monroe, NC
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340130
Location600 Hospital DrMonroe, NC 28112 · Union County
Emergency services Birthing friendly

Atrium Health University City

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number340166
Location8800 North Tyron StreetCharlotte, NC 28262 · Mecklenburg County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28204 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.35/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality84.22
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 12

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) E0465
DME-Other DME · category DE005N
1 supplier12 claims12 services$784.18 avg. paid by Medicare
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) E0466
DME-Other DME · category DE005N
3 suppliers23 claims23 services$921.90 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
2 suppliers14 claims14 services$32.18 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
8 suppliers87 claims87 services$64.11 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
6 suppliers41 claims41 services$28.24 avg. paid by Medicare
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms J7605
DME-Drugs Administered Through DME · category DG006N
2 suppliers32 claims1,920 services$4.39 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1237 HARDING PL, STE 4300
CHARLOTTE, NC 28204
Internal Medicine (Cardiovascular Disease)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Nurse Practitioner (Family)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Nurse Practitioner
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Internal Medicine (Cardiovascular Disease)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Internal Medicine (Cardiovascular Disease)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204
Internal Medicine (Cardiovascular Disease)
1237 HARDING PL, STE 3100
CHARLOTTE, NC 28204

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 Justin Swartz's NPI number?

The NPI number for Justin Swartz is 1497930499. It was assigned to this individual provider in the NPPES registry on January 8, 2008.

Where is Justin Swartz located?

Justin Swartz practices at 1237 Harding Pl Ste 3200, Charlotte, NC 28204. The listed phone number is (704) 355-5375.

What is Justin Swartz's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Justin Swartz enrolled in Medicare?

Yes. Justin Swartz is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Justin Swartz accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Blue Cross and Blue Shield of NC and BlueCross BlueShield of South Carolina and 3 other insurers list Justin Swartz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Justin Swartz affiliated with any hospitals?

According to CMS data, Justin Swartz is affiliated with Atrium Health Cleveland, Atrium Health Pineville, Carolinas Medical Center/Behav Health, Atrium Health Union and Atrium Health University City.

When was this NPI record last updated?

The NPPES record for Justin Swartz was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.