Waccamaw Urology Associates

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

12505SC Issued in SC

Legal business name

WACCAMAW UROLOGY ASSOCIATES

Practice address

3911A Highway 17
Murrells Inlet, SC 29576-5014

Phone

(438) 652-4000

Fax

(843) 652-4004

NPI assigned

Oct 26, 2006

Last updated

Dec 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas S Cerasaro, MDNPI 1295765402

Title

President

Phone

(842) 833-3428

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas S Cerasaro, MD

  • Urology Physician
  • Murrells Inlet, SC
  • NPI 1295765402
  Medicare reassignment NPD Authorized official
• Vesna Solheim, M.D.

  • Family Medicine Physician
  • Murrells Inlet, SC
  • NPI 1528043528
  NPD
• Walter R Frank III, MD

  • Urology Physician
  • Georgetown, SC
  • NPI 1245258417
  NPD (past)
• Frederick Leon Polando, P.A

  • Physician Assistant
  • Georgetown, SC
  • NPI 1265537021
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1144305202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 HIGHWAY 17 STE A",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765014",
            "telephone_number": "438-652-4000",
            "fax_number": "843-652-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911A HIGHWAY 17",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295765014",
            "telephone_number": "438-652-4000",
            "fax_number": "843-652-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW UROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "CERASARO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "842-833-3428",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "12505SC",
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "17277",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0856",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Waccamaw Pain Partners PA
• Wal-Mart Stores East LP (WalMart Pharmacy 10-5705)
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• Wal-Mart Stores East, LP (Wal-Mart Vision Center 30-5705)
• Walgreen Co (Walgreens #06077)
• Walgreen Co (Rite Aid #11633)

• Urology Physician in Murrells Inlet, SC
• Providers in Murrells Inlet, SC by specialty
• Urology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.