Individual provider Active NPI

Mark Gary Buchanan, M.D.

  • Urology Physician
  • Charleston, SC
National Provider Identifier
1104825637
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
019842 Issued in SC
Practice address
1470 Tobias Gadson Blvd
Suite 201
Charleston, SC 29407-4707
Phone
(843) 556-7060
Fax
(843) 556-9960
NPI assigned
Jul 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 019842 SC Primary

Addresses

Primary practice location

1470 Tobias Gadson Blvd
Suite 201
Charleston, SC 29407-4707

Mailing address

2687 Lake Park Dr
N Charleston, SC 29406-9100
Phone (843) 572-0097

Other identifiers 2

IdentifierTypeStateIssuer
198427MedicaidSC
20 4068094OtherSCTAX ID

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
I20060725000136 SC Practitioner - Urology 7012920853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Tennessee, HSC, College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lowcountry Urology Clinics, PAGroup PAC ID 6406869247, 14 clinicians

Practice addresses (Care Compare)

1470 Tobias Gadson Blvd
Charleston, SC 29407-4707
Phone (843) 556-7060

2687 Lake Park Dr
North Charleston, SC 29406-9100
Phone (843) 572-1010

295 A Midland Pkwy
Suite 100
Summerville, SC 29485-5901
Phone (843) 871-5220

641 Saint Andrews Blvd
Charleston, SC 29407-7165
Phone (843) 766-4070

Hospital & facility affiliations

  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection13

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019842SCMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lowcountry Urology Clinics PA Urology CurrentSince Aug 7, 2006 Accepting new patients
Lowcountry Urology Clinics, PA Urology CurrentSince Aug 7, 2006 Accepting new patients
Lowcountry Urology Clinics, PA Past Accepting new patients

Locations

1470 Tobias Gadson Blvd
Ste 201
Charleston, SC 29407
Phone (843) 556-7060

125 Doughty St
Ste 390
Charleston, SC 29403
Phone (843) 577-2160

641 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 577-6015

9231 Medical Plaza Dr
Ste B
North Charleston, SC 29406
Phone (843) 863-9005

2687 Lake Park Dr
North Charleston, SC 29406
Phone (843) 572-0097

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.

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487289600000",
    "number": "1104825637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2687 LAKE PARK DR",
            "city": "N CHARLESTON",
            "state": "SC",
            "postal_code": "294069100",
            "telephone_number": "843-572-0097",
            "fax_number": "843-725-3118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 TOBIAS GADSON BLVD",
            "address_2": "SUITE 201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074707",
            "telephone_number": "843-556-7060",
            "fax_number": "843-556-9960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCHANAN",
        "first_name": "MARK",
        "middle_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2017-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "019842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198427",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20 4068094",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.