| Alzheimer's Memory Center | |
|
10801 Monroe Rd Ste 100 Matthews NC 28105-8336 | |
| (704) 364-4000 | |
| (704) 364-4005 |
| Full Name | Alzheimer's Memory Center |
|---|---|
| Speciality | Contractor |
| Location | 10801 Monroe Rd Ste 100, Matthews, North Carolina |
| Authorized Official Name and Position | Mohammad R. Bolouri (MD) |
| Authorized Official Contact | 7043644000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alzheimer's Memory Center 10801 Monroe Rd Ste 100 Matthews NC 28105-8336 Ph: (704) 364-4000 | Alzheimer's Memory Center 10801 Monroe Rd Ste 100 Matthews NC 28105-8336 Ph: (704) 364-4000 |
| NPI Number | 1457530057 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 08/10/2026 |
| Certification Date | 08/10/2026 |
| Medicare PECOS PAC ID | 8022188549 |
|---|---|
| Medicare Enrollment ID | O20080617000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457530057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Secondary |
| 171W00000X | Contractor | 200400301 (North Carolina) | Primary |
| Provider Name | Mohammad R Bolouri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659322691 PECOS PAC ID: 1658315619 Enrollment ID: I20080617000635 |
| Provider Name | Srishti Lipsa Bhagat |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891229449 PECOS PAC ID: 1456638550 Enrollment ID: I20210818002822 |
| Provider Name | Cassidy Marie Modesti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225860729 PECOS PAC ID: 4183137524 Enrollment ID: I20250630002610 |
| Provider Name | Velukumar Nanjagowder |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1700945847 PECOS PAC ID: 6608806518 Enrollment ID: I20250912000753 |
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