Mark S Principe, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

583 Issued in SC

Practice address

180 Wingo Way
Suite 304
Mt Pleasant, SC 29464-1810

Phone

(843) 884-8045

Fax

(843) 881-5081

NPI assigned

Jul 21, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.principe@rsfpp.eclinicaldirectplus.com

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.

• Roper Saint Francis Physicians Network

  • Surgery Physician
  • Charleston, SC
  • NPI 1124431606
  Medicare reassignment
• Roper Saint Francis Physicians Network

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Murrells Inlet, SC
  • NPI 1508009812
  NPD
• Roper Saint Francis Physicians Network

  • Obstetrics & Gynecology Physician
  • Charleston, SC
  • NPI 1811857352
  NPD

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1023017993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751649",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751649",
            "telephone_number": "843-789-1620",
            "fax_number": "843-724-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 WINGO WAY",
            "address_2": "SUITE 304",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294641810",
            "telephone_number": "843-884-8045",
            "fax_number": "843-881-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCIPE",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0431PA",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID-RSFPN",
            "identifier": "P00930476",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Mark.Principe@rsfpp.eclinicaldirectplus.com",
            "affiliation": "N",
            "endpointDescription": "Document and CCD Exchange",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient Care Documents",
            "address_1": "180 Wingo Way",
            "address_2": "Suite 304",
            "city": "MT Pleasant",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294641810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jaime Priddy, RN
• Primary Care Optometry
• Prime Core Care LLC
• Prime Path EMS LLC
• Margaux Caroline Princi, PT
• Lauryn Prioleau, PHARMD
• Gabrielle Pritchett
• John Travis Pritchett, M.D.
• Pro Active Health & Wellness LLC
• Proactive MD SC,P.a.

• Medical Physician Assistant in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Medical Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.