NPIMap

Individual provider Active NPI

Maribeth A Carletta, PA-C

  • Surgical Physician Assistant
  • Little River, SC
National Provider Identifier
1083710446
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
4711 Issued in SC
Practice address
3600 Sea Mountain Hwy Ste B
Little River, SC 29566-8161
Phone
(843) 399-9696
NPI assigned
Sep 15, 2006
Last updated
Apr 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 006082 NY
Surgical Physician Assistant 363AS0400X 4711 SC Primary

Addresses

Primary practice location

3600 Sea Mountain Hwy Ste B
Little River, SC 29566-8161

Mailing address

3600 Sea Mountain Hwy Ste B
Little River, SC 29566-8161
Phone (843) 399-9696

Other names 1

  • Maribeth Widas Former name

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
I20231109000126 SC Practitioner - Physician Assistant 7113103219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of New York at Stony Brook, School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthosc LLCGroup PAC ID 8022370030, 113 clinicians

Practice addresses (Care Compare)

1621 Hwy 17 N
North Myrtle Beach, SC 29582-2229
Phone (843) 353-3460

210 Village Ctr Blvd
Myrtle Beach, SC 29579-6706

2376 Cypress Cir
Suite 300
Conway, SC 29526-8995
Phone (843) 353-3460

3545 Hwy 17
Unit 200
Murrells Inlet, SC 29576-5113
Phone (843) 353-3460

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.45 of 100Reported as group
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006082NYMDMental Health Counselor
4711SCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthosc, LLC CurrentSince Oct 25, 2023 Accepting new patients
Orthosc, LLC CurrentSince Oct 25, 2023 Accepting new patients
Orthosc, LLC PastSince May 29, 2022 Accepting new patients

Locations

2376 Cypress Cir
Ste 300
Conway, SC 29526
Phone (843) 347-7222

210 Village Center Blvd
Ste 140
Myrtle Beach, SC 29579
Phone (843) 333-8385

3620 Walton Dr
Unit C5
Myrtle Beach, SC 29577

1621 Highway 17 N
North Myrtle Beach, SC 29582
Phone (843) 427-0592

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17161/brand/1/csg/1/fhir/r4
  • Direct secure messaging: maribeth.carletta.1@17161.direct.athenahealth.com

Organizations & group practices 3

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 4

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1083710446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 SEA MOUNTAIN HWY STE B",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668161",
            "telephone_number": "843-399-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 SEA MOUNTAIN HWY STE B",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668161",
            "telephone_number": "843-399-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLETTA",
        "first_name": "MARIBETH",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "006082",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SC",
            "license": "4711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIBETH",
            "last_name": "WIDAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.