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DR. MICHAEL THOMAS FALCONE M.D.
NPI 1629282371
Otolaryngology in Charlotte, NC

Active since May 10, 2007PECOS EnrolledAccepts Medicare Assignment
95.35/100
CMS Quality Rating
2325 W ARBORS DR, SUITE 201, CHARLOTTE, NC 28262(704) 295-3500(704) 295-3506 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 26, 2021, May 3, 2018 (2 updates tracked since 2018).

About Dr. Michael Thomas Falcone M.d. NPPES

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

DR. MICHAEL THOMAS FALCONE M.D. (NPI 1629282371) is an individual otolaryngology provider in Charlotte, North Carolina, licensed in North Carolina (2009-00513) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and is a graduate of University Of Florida College Of Medicine (2004).

NPPES Registry Identity

NPI1629282371
Entity TypeIndividualMale
Primary Taxonomy207Y00000X
Provider Legal NameDR. MICHAEL THOMAS FALCONECredential: M.D.
Location Address2325 W ARBORS DR, SUITE 201Charlotte, NC 28262-2663
Mailing Address6035 Fairview RdCharlotte, NC 28210-3256 · (704) 295-3000 · Fax (704) 838-8494
Phone(704) 295-3500
Fax(704) 295-3506
Sole ProprietorNo
Medical School CMSUniversity Of Florida College Of MedicineGraduated 2004
Enumeration DateMay 10, 2007
Last NPPES UpdateApril 26, 20212 updates tracked since enumeration
NPPES CertifiedApril 26, 2021
✔ NPI 1629282371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians
Taxonomy Code207Y00000X
Licenses✔ Licensed in NC · 2009-00513✔ Licensed in TN · 40706
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
2325 W ARBORS DR, Charlotte, NC 28262
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Other Identifiers 6

Other15343NC · Bcbsnc
Other20093779SC · Select Health Of Sc
MedicaidN0051GSC
Other000000290273SC · Unison Health Plan Of Sc
Medicaid5911503NC
Other9494314Aetna

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, Molina Healthcare and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Thomas Falcone M.d. 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 ID2163576992
PECOS Enrollment IDI20090813000463
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.

Medicare Billing Reassignment

Medicare enrollment records show Michael Falcone reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Charlotte Eye Ear Nose & Throat Associates, P.A.
14 mi
Ophthalmology
6035 FAIRVIEW RD
Charlotte, NC 28210
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Charlotte Eye Ear Nose & Throat Associates PA
  • 181 clinicians in this Medicare group
NPI 1043287469 (704) 295-3000

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

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 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.
181 services146 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
71 services71 patients
Professional service for multiple injections of allergen 95117
The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.
53 services12 patients
Removal of impacted ear wax 69210
Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.
49 services42 patients
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.
48 services42 patients
Diagnostic exam of voice box using a flexible endoscope 31575
This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.
44 services38 patients

Hospital Affiliations CMS Care Compare 3

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

Novant Health Presbyterian Medical Center

Acute Care Hospitals · Charlotte, NC
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340053
Location200 Hawthorne Lane Box 33549Charlotte, NC 28233 · 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 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 28262 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
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
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

Other Providers at the Same Location NPPES 6

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

SHARON L HOLLEY DMD MONIQUE D MCEAHERN DDS ROBERT M SELDEN III DDS MS
Clinic/Center (Dental)
2325 W ARBORS DR, SUITE 104
CHARLOTTE, NC 28262
Mecklenburg County (704) 688-1664
CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Ophthalmology
2325 W ARBORS DR, SUITE 201
CHARLOTTE, NC 28262
Mecklenburg County (704) 295-3500
DR. HUGH M LOVEJOY JR. M.D.
Otolaryngology
2325 W ARBORS DR, SUITE 201
CHARLOTTE, NC 28262
Mecklenburg County (704) 295-3000
MARGARET DANIELLE FUNNY DDS PLLC
Dentist (Pediatric Dentistry)
2325 W ARBORS DR, SUITE 104
CHARLOTTE, NC 28262
Mecklenburg County (704) 688-1664
DR. SUMIT KUMAR GUPTA MD
Ophthalmology
2325 W ARBORS DR, SUITE 201
CHARLOTTE, NC 28262
Mecklenburg County (704) 295-3500
DR. MICHAEL S MALLONEE MD
Otolaryngology
2325 W ARBORS DR, SUITE 201
CHARLOTTE, NC 28262
Mecklenburg County (704) 295-3000

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 Michael Falcone's NPI number?

The NPI number for Michael Falcone is 1629282371. It was assigned to this individual provider in the NPPES registry on May 10, 2007.

Where is Michael Falcone located?

Michael Falcone practices at 2325 W Arbors Dr Suite 201, Charlotte, NC 28262. The listed phone number is (704) 295-3500.

What is Michael Falcone's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Michael Falcone enrolled in Medicare?

Yes. Michael Falcone 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.

Which organization bills Medicare for Michael Falcone's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Michael Falcone reassigns Medicare benefits to Charlotte Eye Ear Nose & Throat Associates, P.A. (Charlotte, NC). The 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 Michael Falcone's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Michael Falcone accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of NC, Molina Healthcare and UnitedHealthcare list Michael Falcone 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 Michael Falcone affiliated with any hospitals?

According to CMS data, Michael Falcone is affiliated with Novant Health Presbyterian Medical Center, Carolinas Medical Center/Behav Health and Atrium Health University City.

When was this NPI record last updated?

The NPPES record for Michael Falcone was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.