Nachiket Nitin Datar

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2021030733 Issued in MO

Practice address

809 82ND Parkway Grand Strand Medical Center/
Gme Office
Myrtle Beach, SC 29572

Phone

(843) 848-4679

Fax

(843) 848-4682

NPI assigned

Jun 19, 2018

Reactivated

Mar 11, 2019

Last updated

Nov 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, SC2 enrollments

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 2

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Coastal Carolina Primary Care LLCGroup PAC ID 3577629088, 24 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Coastal Carolina Primary Care, LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Myrtle Beach, SC
  • NPI 1821257676
  Medicare reassignment Care Compare group NPD
• Southeastern Hospitalist Services PC

  • Hospitalist Physician
  • Myrtle Beach, SC
  • NPI 1003280108

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Cogent Healthcare of Missouri, Inc

  • Critical Care Medicine (Internal Medicine) Physician
  • Fenton, MO
  • NPI 1780961599
  Medicare reassignment NPD
• Sound Physicians of Illinois, LLC

  • Hospitalist Physician
  • Bridgeton, MO
  • NPI 1043598865

  Family Medicine

  Medicare reassignment NPD
• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  NPD (past)

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

• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1104310671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 82ND PARKWAY GRAND STRAND MEDICAL CENTER/",
            "address_2": "GME OFFICE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-848-4679",
            "fax_number": "843-848-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PARKWAY GRAND STRAND MEDICAL CENTER/",
            "address_2": "GME OFFICE",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29572",
            "telephone_number": "843-848-4679",
            "fax_number": "843-848-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATAR",
        "first_name": "NACHIKET",
        "middle_name": "NITIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "deactivation_date": "2019-01-25",
        "reactivation_date": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021030733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Walls Daniels
• Frederick William Daniels, MD
• Laura M Daniels, DPT
• Zachary Tyler Daniels, DPT
• Jonathan Darling
• Joseph J Davey, M.D.
• Tara Davis-Boyd, NP
• Amanda Davis
• Bill Hampton Davis, M.D.
• David R Davis, CRNA

• Family Medicine Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.