MEDICARE: TRILLIUM MEDICAL PARTNERS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RS0012X	Sleep Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1104779818
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILLIUM MEDICAL PARTNERS PC

Provider Business Mailing Address
First Line	:	200 FORSYTHE ST
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28303-5426
Country	:	US
Telephone Number	:	919-367-6456
Fax Number	:

Provider Business Practice Location Address
First Line	:	4001 TRISTA LN
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28306-0053
Country	:	US
Telephone Number	:	919-367-6456
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DR. RAHUL KAKKAR
Credential	:	MD
Telephone Number	:	919-897-9049

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	05/06/2026

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