NPIMap

Individual provider Active NPI

Nicholas C. Shaheen, MD

  • Neuroradiology Physician
  • Mount Pleasant, SC
National Provider Identifier
1023471208
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
84928 Issued in SC
Practice address
1114 Rosewood LN
Mount Pleasant, SC 29464-3259
Phone
(843) 906-7578
NPI assigned
Apr 4, 2016
Last updated
Aug 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Neuroradiology Physician 2085N0700X 84928 SC Primary

Addresses

Primary practice location

1114 Rosewood LN
Mount Pleasant, SC 29464-3259

Mailing address

1114 Rosewood LN
Mount Pleasant, SC 29464-3259
Phone (843) 906-7578

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210902001644 SC Practitioner - Diagnostic Radiology 8729378377 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican II LLCGroup PAC ID 1759484082, 18 clinicians
Charleston Radiologists PAGroup PAC ID 9436054715, 35 clinicians

Practice addresses (Care Compare)

1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone (843) 881-4020

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (866) 717-9687

2880 Tricom St
N Charleston, SC 29406-9171
Phone (843) 797-5050

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (866) 717-9687

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (866) 717-9687

622 Johnnie Dodds Blvd
Mt Pleasant, SC 29464-3013
Phone (843) 824-0606

8330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (866) 717-9687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
79.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
84928SCMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Radiology and Interventional Associates Inc CurrentSince Aug 1, 2021 Accepting new patients
Lucidsolutions, Inc. Neuroradiology CurrentSince Aug 1, 2021 Accepting new patients
Charleston Radiologists PA CurrentSince Jun 1, 2022 Accepting new patients
Pelican II, LLC Neuroradiology CurrentSince Jun 1, 2022 Accepting new patients

Locations

100 E Campus View Blvd
Ste 100
Columbus, OH 43235
Phone (614) 340-7747

3535 Olentangy River Rd
Columbus, OH 43214
Phone (614) 566-1997

1241 Woodland Ave
Mt Pleasant, SC 29464
Phone (843) 881-4020

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1459728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1023471208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 ROSEWOOD LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643259",
            "telephone_number": "843-906-7578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 ROSEWOOD LN",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643259",
            "telephone_number": "843-906-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "NICHOLAS",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-04",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "SC",
            "license": "84928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.