Matthew Walter Jaenicke, M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

38299 Issued in SC

Practice address

890 Johnnie Dodds Blvd Suite 2a
Mt Pleasant, SC 29464

Phone

(843) 881-9971

Fax

(843) 881-9973

NPI assigned

Jun 4, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Rheumatology

Education

Medical University of South Carolina College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Cooper Rheumatology, PAGroup PAC ID 1254461973, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: matthew.jaenicke.p1@direct.ecrheum.nextgenshare.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.

• East Cooper Rheumatology, PA

  • Rheumatology Physician
  • Mount Pleasant, SC
  • NPI 1932435039
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Roper St. Francis Mount Pleasant Hospital

  • General Acute Care Hospital
  • Mt Pleasant, SC
  • NPI 1255645644
  Care Compare affiliation

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1063892008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 JOHNNIE DODDS BLVD SUITE 2A",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-881-9971",
            "fax_number": "843-881-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 JOHNNIE DODDS BLVD SUITE 2A",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-881-9971",
            "fax_number": "843-881-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAENICKE",
        "first_name": "MATTHEW",
        "middle_name": "WALTER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2025-04-24",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VT",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "SC",
            "license": "38299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000030538",
            "state": "VT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matthew.jaenickemd.p1@direct.cacsc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1711 Saint Julian Pl",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292042409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Richard J Jackowski, DDS
• Grayson Jackson, PT
• Jacquelyn Marie Jackson
• Rachel Jackson
• Zachary Jacobelli, PA-C
• Steven Jesse Jahnke, LPC
• James Bradley Majors
• James Island Physical Therapy
• Candra Gilliard James, LPC
• Mary Henderson James, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.