Individual provider Active NPI

Kamran Zargham Koranloo, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Columbia, SC
National Provider Identifier
1013022516
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
23150 Issued in SC
Practice address
1821 Clemson Rd
Columbia, SC 29229-7832
Phone
(803) 788-5916
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 23150 SC Primary

Addresses

Primary practice location

1821 Clemson Rd
Columbia, SC 29229-7832

Mailing address

115 Atrium Way
Ste 235
Columbia, SC 29223
Phone (803) 788-5916

Other practice location 1

146 N Hospital Dr Ste 120
West Columbia, SC 29169-4800
Phone (803) 935-8410

Other identifiers 1

IdentifierTypeStateIssuer
231500MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050804000629 SC Practitioner - Anesthesiology 0446289094 Reassigns benefits to 2 organizations
I20200521002973 GA Practitioner - Pain Management 0446289094

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1821 Clemson Rd
Columbia, SC 29229-7832
Phone (803) 788-5916

Hospital & facility affiliations

  • Pruitthealth Home Health-Columbia Home health agency, Columbia, SC, CCN 427130

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Apr 9, 2018 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Apr 9, 2018 Accepting new patients
Prisma Health Medical Group-Midlands Current Accepting new patients
Mobile Diagnostics, LLC Pain Medicine Past Accepting new patients

Locations

14 Richland Medical Park Dr
Ste 200
Columbia, SC 29203
Phone (803) 296-9200

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1013022516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 ATRIUM WAY",
            "address_2": "STE 235",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29223",
            "telephone_number": "803-788-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297832",
            "telephone_number": "803-788-5916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 N Hospital Dr Ste 120",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694800",
            "country_code": "US",
            "telephone_number": "803-935-8410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZARGHAM KORANLOO",
        "first_name": "KAMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "23150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "231500",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.