Individual provider Active NPI

Lopa Sisodia Bhansaly, D.O.

  • Family Medicine Physician
  • Greer, SC
National Provider Identifier
1154642726
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1402 Issued in SC
Practice address
109 Physicians Dr Ste a
Greer, SC 29650-2446
Phone
(864) 797-9150
NPI assigned
Jun 18, 2010
Last updated
Apr 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1402 SC Primary

Addresses

Primary practice location

109 Physicians Dr Ste a
Greer, SC 29650-2446

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8617

Other identifiers 2

IdentifierTypeStateIssuer
014022MedicaidSC
SC15433365OtherSCMEDICARE PTAN

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
I20130919000349 SC Practitioner - Family Practice 2961640545 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spartanburg Medical CenterGroup PAC ID 3072425297, 1,060 clinicians

Practice addresses (Care Compare)

2801 Woodruff Rd
Suite 101
Simpsonville, SC 29681-4807
Phone (864) 849-9170

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1402SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Aug 21, 2017 Accepting new patients
Greenville Health System CurrentSince Sep 1, 2013 Accepting new patients
Prisma Health University Medical Group Family Medicine Current Accepting new patients
Spartanburg Medical Center Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Greenville Health System Current Accepting new patients
Emergencymd Family Medicine CurrentSince Nov 1, 2016 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Emergency Physician Services Past Accepting new patients

Locations

75 Remittance Dr
Dept 1363
Chicago, IL 60675

2400 Boiling Springs Rd
Ste A
Boiling Springs, SC 29316
Phone (864) 599-0731

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

11402 Anderson Rd
Ste A
Greenville, SC 29611
Phone (864) 631-2799

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

2498 N Pleasantburg Dr
Ste A
Greenville, SC 29609
Phone (864) 236-4350

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

109 Physicians Dr
Ste A
Greer, SC 29650
Phone (864) 797-1050

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

1115 Wren School Rd
Piedmont, SC 29673
Phone (864) 859-0740

2801 Woodruff Rd
Ste 101
Simpsonville, SC 29681
Phone (864) 849-9170

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1154642726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PHYSICIANS DR STE A",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502446",
            "telephone_number": "864-797-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANSALY",
        "first_name": "LOPA",
        "middle_name": "SISODIA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "1402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014022",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SC15433365",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.