ALBERT PETRUS WIRAWAN RN, NP-C, MSN
NPI 1831461987
Nurse Practitioner in Charlotte, NC

Q: What is Albert Wirawan's NPI number?

The NPI number for Albert Wirawan is 1831461987. It was assigned to this individual provider in the NPPES registry on February 6, 2012.

Q: What is Albert Wirawan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Albert Wirawan was last updated on October 29, 2020. 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.

Active since February 06, 2012PECOS EnrolledAccepts Medicare Assignment

200 HAWTHORNE LN, CHARLOTTE, NC 28204(704) 384-5416(704) 384-5992 Get Directions Write a Review

NPPES record last updated: October 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 29, 2020, Jan 23, 2017 (2 updates tracked since 2017).

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About Albert Petrus Wirawan Rn, Np-c, Msn NPPES

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

ALBERT PETRUS WIRAWAN RN, NP-C, MSN (NPI 1831461987) is an individual nurse practitioner in Charlotte, North Carolina, licensed in North Carolina (5005467) and active in the NPI registry since February 2012. He is enrolled in Medicare PECOS, is affiliated with Novant Health Presbyterian Medical Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1831461987

Entity TypeIndividualMale

Primary Taxonomy363L00000X

Provider Legal NameALBERT PETRUS WIRAWANCredential: RN, NP-C, MSN

Location Address200 HAWTHORNE LNCharlotte, NC 28204-2515

Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-5416 · Fax (704) 384-5992

Phone(704) 384-5416

Fax(704) 384-5992

Sole ProprietorNo

Medical School CMSOtherGraduated 2011

Enumeration DateFebruary 6, 2012

Last NPPES UpdateOctober 29, 20202 updates tracked since enumeration

NPPES CertifiedOctober 29, 2020

✔ NPI 1831461987 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in NC · 5005467

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 5005467 (NC)

200 HAWTHORNE LN, Charlotte, NC 28204

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Other Identifiers 1

Medicaid1831461987NC

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

Albert Petrus Wirawan Rn, Np-c, Msn 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 ID2062673700

PECOS Enrollment IDI20120405000520

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.

Hospital Affiliations CMS Care Compare

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

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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

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.

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.

WELO SYLVIE OLENGA CRNA

Nurse Anesthetist, Certified Registered