Individual provider Active NPI

Kamran Borhanian, MD

  • Surgery Physician
  • Rock Hill, SC
National Provider Identifier
1053371609
Registry record updated Dec 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
12626 Issued in SC
Practice address
200 S. Herlong Ave.
Suite G
Rock Hill, SC 29732-1182
Phone
(803) 909-6300
Fax
(803) 909-6310
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 12626 SC Primary
Surgery Physician 208600000X 122154 NC

Addresses

Primary practice location

200 S. Herlong Ave.
Suite G
Rock Hill, SC 29732-1182

Mailing address

200 S. Herlong Ave
Suite G
Rock Hill, SC 29732-6548
Phone (803) 909-6300

Other identifiers 3

IdentifierTypeStateIssuer
126269MedicaidSC
122154OtherNCLICENSE NUMBER
890509XMedicaidNC

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
I20110201000253 SC Practitioner - General Surgery 8325135304 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
122154NCMDSurgery Physician
12626SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II Surgery CurrentSince Mar 13, 2020 Accepting new patients
McLeod Physician Associates II CurrentSince Mar 13, 2020 Accepting new patients
Piedmont Physician Network LLC Surgery CurrentSince Oct 23, 2017 Accepting new patients
Palmetto Surgery LLC Surgery PastSince Dec 16, 1996 Accepting new patients

Locations

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

506 E Cheves St
#202
Florence, SC 29506

200 Herlong Ave S
Ste G
Rock Hill, SC 29732
Phone (803) 325-1770

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

200 Herlong Ave S
Ste E
Rock Hill, SC 29732
Phone (803) 324-1950

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14929/brand/3/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387756800000",
    "number": "1053371609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S. HERLONG AVE",
            "address_2": "SUITE G",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297326548",
            "telephone_number": "803-909-6300",
            "fax_number": "803-909-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S. HERLONG AVE.",
            "address_2": "SUITE G",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321182",
            "telephone_number": "803-909-6300",
            "fax_number": "803-909-6310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORHANIAN",
        "first_name": "KAMRAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2013-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "12626",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "122154",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126269",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "122154",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890509X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.