Individual provider Active NPI

Michael Robert Hoffman, MD

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1114908142
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
08302 Issued in SC
Practice address
158 Milestone Way
Greenville, SC 29615-6616
Phone
(864) 627-4478
Fax
(864) 627-4479
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 08302 SC Primary
Obstetrics & Gynecology Physician 207V00000X 2016-00822 NC

Addresses

Primary practice location

158 Milestone Way
Greenville, SC 29615-6616

Mailing address

158 Milestone Way
Greenville, SC 29615-6616
Phone (864) 627-4478

Other identifiers 1

IdentifierTypeStateIssuer
083028MedicaidSC

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
I20151112003038 SC Practitioner - Obstetrics/Gynecology 5395726061 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016-00822NCMDObstetrics & Gynecology Physician
08302SCMDObstetrics & Gynecology Physician
8302SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Dec 30, 2016 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Dec 30, 2016 Accepting new patients
The Regional Medical Center of Orangeburg and Calhoun Counties Current Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties CurrentSince Dec 30, 2016 Accepting new patients

Locations

1097B Cook Rd
Orangeburg, SC 29118
Phone (803) 534-5110

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

651A Harry C Raysor Dr
St Matthews, SC 29135
Phone (803) 395-3737

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0fba742b-eec1-4103-87e5-edbdf1fe1e30/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1114908142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 MILESTONE WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156616",
            "telephone_number": "864-627-4478",
            "fax_number": "864-627-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 MILESTONE WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156616",
            "telephone_number": "864-627-4478",
            "fax_number": "864-627-4479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "MICHAEL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "08302",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2016-00822",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083028",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.