Marie Lorraine Alquisalas Cesa
Individual provider Active NPI Internal Medicine Physician · Graniteville, SC
NPI 1013495670 · NPPES record last updated Oct 26, 2021
Key facts
- NPI
- 1013495670
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 86692 (SC)
- Practice address
- 124 Bettis Academy Rd
Graniteville, SC 29829-3107 - Phone
- (803) 392-3724
- Fax
- (803) 234-5593
- NPI assigned
- Aug 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Aiken Professional Association LLC
Practice addresses (Care Compare)
124 Bettis Academy Rd
Graniteville, SC 29829-3107
Phone (803) 392-3724
Hospital & facility affiliations
- Centerwell Home Health
- Aiken Regional Medical Center
- Wellstar MCG Health, Affiliated With Med Col
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210903002721 | SC | Practitioner - Internal Medicine | 8729328448 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aiken Professional Association LLC | Family Medicine | Current |
Accepting new patients |
| Aiken Professional Association, LLC | Family Medicine | Current |
Accepting new patients |
Locations
367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422
137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589
124 Bettis Academy Rd
Graniteville, SC 29829
Phone (803) 392-3724
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/6d80f5c7-212b-4be1-9709-7bad9391b694/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 86692 | SC | Yes |
Addresses
Primary practice location
124 Bettis Academy Rd
Graniteville, SC 29829-3107
Mailing address
367 S Gulph Rd
Attn Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (803) 392-3724
Other providers in Graniteville, SC
- Aiken Professional Association LLC
- Aiken Urgent Care
- Bestsolutionhomecare,LLC
- Bettis Academy Dentistry, LLC
- Pamela Mae Byrd
- Tiffany Renee Cheatham
- Christy Sikes, LLC.
- Converge Counseling
- Discovering Beautiful Minds, LLC
- Mae Jean Englee
All providers in Graniteville, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.