Individual provider Active NPI

Cameron Pappas, PA

  • Medical Physician Assistant
  • Greenville, SC
National Provider Identifier
1104579986
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
28 Medical Ridge Dr
Greenville, SC 29605-4267
Phone
(864) 271-7440
NPI assigned
Feb 1, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

28 Medical Ridge Dr
Greenville, SC 29605-4267

Mailing address

6601 Vaught Ranch Rd Ste 200
Austin, TX 78730-2309
Phone (512) 628-0465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705001066 GA Practitioner - Physician Assistant 1850761198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Skin Care Physicians of Georgia, P.C..Group PAC ID 7517850712, 15 clinicians

Practice addresses (Care Compare)

1210 Commerce Dr
Suite 113114
Greensboro, GA 30642-7447
Phone (478) 742-2180

308 Coliseum Dr
Macon, GA 31217-3861
Phone (478) 742-2180

910 N 5TH St
Cordele, GA 31015-3254
Phone (229) 271-4652

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
81.19
Promoting interoperability
99
Improvement activities
40
Cost
34.65

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Consultants of Albuquerque PC Single Specialty PastSince Feb 1, 2022 Accepting new patients
Epiphany Dermatology of New Mexico, LLC Single Specialty PastSince Feb 1, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1104579986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 VAUGHT RANCH RD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787302309",
            "telephone_number": "512-628-0465",
            "fax_number": "512-233-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 MEDICAL RIDGE DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054267",
            "telephone_number": "864-271-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "CAMERON",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.