Individual provider Active NPI

Stephen Walter Bielsky, M.D.

  • Urology Physician
  • Charleston, SC
National Provider Identifier
1023017589
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
9228 Issued in SC
Practice address
1470 Tobias Gadson Blvd
Suite 201
Charleston, SC 29407-4707
Phone
(843) 556-7060
Fax
(843) 556-9960
NPI assigned
Jul 18, 2005
Last updated
Feb 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 9228 SC Primary

Addresses

Primary practice location

1470 Tobias Gadson Blvd
Suite 201
Charleston, SC 29407-4707

Mailing address

2687 Lake Park Dr
N Charleston, SC 29406-9100
Phone (843) 572-0097

Other identifiers 2

IdentifierTypeStateIssuer
20 4068094OtherSCTAX ID
092287MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040407001140 SC Practitioner - Urology 7719882083 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9228SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urology Clinics PA Urology CurrentSince Aug 7, 2006 Accepting new patients
Lowcountry Urology Clinics, PA Urology CurrentSince Aug 7, 2006 Accepting new patients

Locations

1470 Tobias Gadson Blvd
Charleston, SC 29407
Phone (843) 556-2020

641 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 577-6015

1470 Tobias Gadson Blvd
Ste 201
Charleston, SC 29407
Phone (843) 556-7060

125 Doughty St
Ste 390
Charleston, SC 29403
Phone (843) 577-2160

2687 Lake Park Dr
North Charleston, SC 29406
Phone (843) 572-0097

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1023017589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-572-0097",
            "fax_number": "843-725-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 TOBIAS GADSON BLVD",
            "address_2": "SUITE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074707",
            "telephone_number": "843-556-7060",
            "fax_number": "843-556-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIELSKY",
        "first_name": "STEPHEN",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "9228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20 4068094",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092287",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.