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BARBARA ELIZABETH KISSAM MD
NPI 1881689362
Pediatrics - Developmental - Behavioral Pediatrics in Charlotte, NC

Active since September 12, 2005PECOS Enrolled
1900 RANDOLPH RD, SUITE 1010, CHARLOTTE, NC 28207(704) 316-1155(704) 316-1160 Get Directions Write a Review

NPPES record last updated: March 2, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Barbara Elizabeth Kissam Md NPPES

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

BARBARA ELIZABETH KISSAM MD (NPI 1881689362) is an individual developmental - behavioral pediatrics provider in Charlotte, North Carolina, licensed in North Carolina (2006-01118) and active in the NPI registry since September 2005. She is enrolled in Medicare PECOS, maintains a secondary practice location in Winston Salem, and is a graduate of Saint Louis University School Of Medicine (1994).

NPPES Registry Identity

NPI1881689362
Entity TypeIndividualFemale
Primary Taxonomy2080P0006X
Provider Legal NameBARBARA ELIZABETH KISSAMCredential: MD
Location Address1900 RANDOLPH RD, SUITE 1010Charlotte, NC 28207-1122
Mailing Address100 Kimel Forest DrWinston Salem, NC 27103-6074 · (336) 716-2255
Phone(704) 316-1155
Fax(704) 316-1160
Sole ProprietorNo
Medical School CMSSaint Louis University School Of MedicineGraduated 1994
Enumeration DateSeptember 12, 2005
Last NPPES UpdateMarch 2, 2026
NPPES CertifiedMarch 2, 2026
✔ NPI 1881689362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Developmental - Behavioral PediatricsAllopathic & Osteopathic Physicians
Taxonomy Code2080P0006X
License✔ Licensed in NC · 2006-01118
Definition
A developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development.
1900 RANDOLPH RD, Charlotte, NC 28207
Open in Google Maps ↗

Secondary Practice Location 1

Location 12200 Cloverdale AveWinston Salem, NC 27103-2300 · Phone (336) 713-4500 · Fax (336) 713-4501

Other Identifiers 1

Medicaid32568300WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina 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 (PECOS)

Barbara Elizabeth Kissam Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678712916
PECOS Enrollment IDI20260310000480
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 Barbara Kissam reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Wake Forest University Health Sciences
55 mi
Multi-Specialty
1303 GREENSBORO STREET EXT
Lexington, NC 27295
  • Reassigned Medicare billing, North Carolina enrollment
  • 3,003 clinicians in this Medicare group
NPI 1639454499 (336) 716-2255

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

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.

NOVANT HEALTH MEDICAL GROUP, LLC
Internal Medicine (Infectious Disease)
1900 RANDOLPH RD, SUITE 216
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-5416
JOHN B CLARK JR. M.D.
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Mecklenburg County (704) 377-2424
DR. SHANA DALE WALLACE MD
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1900 RANDOLPH RD, SUITE 1010
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1390
SACHIN JAMNADAS HANSALIA M.D.
Internal Medicine (Critical Care Medicine)
1900 RANDOLPH RD, SUITE 580
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-9900
JAMES E PUGH MD
Psychiatry & Neurology (Neurology)
1900 RANDOLPH RD, SUITE 1010
CHARLOTTE, NC 28207
Mecklenburg County (704) 334-7311
DONALD P. RUSH LCSW
Social Worker (Clinical)
1900 RANDOLPH RD, SUITE 800
CHARLOTTE, NC 28207
Mecklenburg County (704) 384-1246
EDWIN T HOLLOWAY M.D.
Emergency Medicine
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Mecklenburg County (704) 377-2424
JOHN W RINGWOOD M.D.
Emergency Medicine (Pediatric Emergency Medicine)
1900 RANDOLPH RD, STE 900
CHARLOTTE, NC 28207
Mecklenburg County (704) 377-2424

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 Barbara Kissam's NPI number?

The NPI number for Barbara Kissam is 1881689362. It was assigned to this individual provider in the NPPES registry on September 12, 2005.

Where is Barbara Kissam located?

Barbara Kissam practices at 1900 Randolph Rd Suite 1010, Charlotte, NC 28207. The listed phone number is (704) 316-1155.

What is Barbara Kissam's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Developmental - Behavioral Pediatrics, with taxonomy code 2080P0006X.

Is Barbara Kissam enrolled in Medicare?

Yes. Barbara Kissam is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Barbara Kissam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Barbara Kissam reassigns Medicare benefits to Wake Forest University Health Sciences (Lexington, 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 Barbara Kissam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Barbara Kissam accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next and 3 other insurers list Barbara Kissam 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.

When was this NPI record last updated?

The NPPES record for Barbara Kissam was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.