Individual provider Active NPI

Daniel Ab Methuselah, DPM

  • Podiatrist
  • Irmo, SC
National Provider Identifier
1093760241
Registry record updated Aug 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0517 Issued in SC
Practice address
7182 Woodrow St Ste 105
Irmo, SC 29063-2832
Phone
(803) 781-3500
Fax
(803) 781-2924
NPI assigned
May 24, 2006
Last updated
Aug 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 0517 SC Primary

Addresses

Primary practice location

7182 Woodrow St Ste 105
Irmo, SC 29063-2832

Mailing address

7182 Woodrow St Ste 105
Irmo, SC 29063-2832
Phone (803) 781-3500

Other identifiers 1

IdentifierTypeStateIssuer
480027811OtherRAILROAD MEDICARE

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001450 SC Practitioner - Podiatry 7012977218 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7182 Woodrow St
Suite 105
Irmo, SC 29063-2958
Phone (803) 781-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50.97 of 100Reported as individual
Quality
65.4
Promoting interoperability
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue125
Removal of nail tissue491
Removal or shaving of skin growth51
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0517SCMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Ab Methuselah DPM LLC Podiatrist CurrentSince Jun 15, 2013 Accepting new patients
Elite Gynecology Past Accepting new patients
Carolina Musculoskeletal Institute PA Past Accepting new patients
Carolina Podiatric Medical Associates, P.a. Podiatrist Past Accepting new patients

Locations

1 Wellness Blvd
Ste 102
Irmo, SC 29063
Phone (803) 638-3946

7182 Woodrow St
Ste 105
Irmo, SC 29063
Phone (803) 781-3500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8321/brand/1/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1093760241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 105",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-781-3500",
            "fax_number": "803-781-2924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7182 WOODROW ST STE 105",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632832",
            "telephone_number": "803-781-3500",
            "fax_number": "803-781-2924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METHUSELAH",
        "first_name": "DANIEL",
        "middle_name": "AB",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "0517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480027811",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

Verify at the official NPI Registry.