Individual provider Active NPI

Kristian O. Hochberg, M.D.

  • Vascular Surgery Physician
  • Charleston, SC
National Provider Identifier
1114930021
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
89491 Issued in SC
Practice address
1327 Ashley River Rd
Charleston, SC 29407-5384
Phone
(843) 577-4551
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 89491 SC Primary

Addresses

Primary practice location

1327 Ashley River Rd
Charleston, SC 29407-5384

Mailing address

1327 Ashley River Rd
Charleston, SC 29407-5384
Phone (843) 577-4551

Other identifiers 1

IdentifierTypeStateIssuer
04197320MedicaidNY

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
I20230816000137 SC Practitioner - Vascular Surgery 9133279870 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Vascular and Vein Center PAGroup PAC ID 4981660479, 11 clinicians

Practice addresses (Care Compare)

1327 Ashley River Rd
Suite B
Charleston, SC 29407-5384
Phone (843) 577-4551

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal181
Leg revascularization (restoring blood flow)57
Removal of tissue31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89491SCMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Vascular & Vein Center, LLC Vascular Surgery CurrentSince Jul 15, 2023 Accepting new patients
Coastal Vascular and Vein Institute LLC Vascular Surgery CurrentSince Oct 23, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1327 Ashley River Rd
Ste B
Charleston, SC 29407
Phone (614) 591-4049

1327 Ashley River Rd
Charleston, SC 29407
Phone (843) 300-3588

1229 Nexton Pkwy
Unit C3
Summerville, SC 29486
Phone (843) 851-9069

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AHDFBA
  • Direct secure messaging: kristian.hochberg@cvvc.eclinicaldirectplus.com

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 3

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1114930021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075384",
            "telephone_number": "843-577-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 ASHLEY RIVER RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075384",
            "telephone_number": "843-577-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOCHBERG",
        "first_name": "KRISTIAN",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "89491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04197320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.