Individual provider Active NPI

Goran Rac, M.D.

  • Urology Physician
  • West Columbia, SC
National Provider Identifier
1104271980
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
89655 Issued in SC
Practice address
222 E Medical LN Ste 101
West Columbia, SC 29169-4850
Phone
(803) 739-3660
Fax
(803) 739-3663
NPI assigned
Apr 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LL39663 SC
Urology Physician 208800000X 036155296 IL
Urology Physician 208800000X 89655 SC Primary

Addresses

Primary practice location

222 E Medical LN Ste 101
West Columbia, SC 29169-4850

Mailing address

PO Box 6069
West Columbia, SC 29171-6069
Phone (803) 791-2000

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address grac142602@direct.luhs.org Other
Direct Messaging Address grac166288@direct.lexmed.com

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
I20230505000666 SC Practitioner - Urology 3173803749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical University of South Carolina College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

103 Summit Centre Dr
Columbia, SC 29229-7613
Phone (803) 382-2450

1111 Knox Abbott Dr
Cayce, SC 29033-3323
Phone (803) 314-0660

1526 Lake Murray Blvd
Columbia, SC 29212-8622
Phone (803) 749-1155

222 E Medical LN
Suite 101
West Columbia, SC 29169-4850
Phone (803) 739-3660

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2460

3016 Longtown Commons Dr
Columbia, SC 29229-7849

557 Columbia Ave
Chapin, SC 29036-8324

565 Columbia Ave
Chapin, SC 29036-8324

707 Old Cherokee Rd
Lexington, SC 29072-9040
Phone (803) 314-9110

76 Polo Rd
Columbia, SC 29223-2806
Phone (803) 699-7255

811 W Main St
Lexington, SC 29072-2500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL39663SCMDSurgery Physician
89655SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington Health Inc Current Accepting new patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc Urology CurrentSince May 1, 2023 Accepting new patients
Lexington Health Inc CurrentSince May 1, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Lexington County Health Services District, Inc. Past Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

222 E Medical Ln
Ste 101
West Columbia, SC 29169
Phone (803) 739-3660

Interoperability endpoints

  • Direct secure messaging: grac166288@direct.lexmed.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1104271980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-791-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MEDICAL LN STE 101",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694850",
            "telephone_number": "803-739-3660",
            "fax_number": "803-739-3663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAC",
        "first_name": "GORAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-28",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "LL39663",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "036155296",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "89655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grac142602@direct.luhs.org",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "grac166288@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "222 E Medical Ln Ste 101",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.