Individual provider Active NPI

Maximilien Jacob Rappaport, D.O.

  • Endocrinology, Diabetes & Metabolism Physician
  • Greenville, SC
National Provider Identifier
1174963953
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35708 Issued in SC
Practice address
877 W Faris Rd Ste D
Greenville, SC 29605-4296
Phone
(864) 455-9031
NPI assigned
Jun 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LL35708 SC
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 02004827A IN
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35708 SC Primary

Addresses

Primary practice location

877 W Faris Rd Ste D
Greenville, SC 29605-4296

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
357082MedicaidSC

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
I20181011001091 SC Practitioner - EndocrinologyPractitioner - Internal Medicine 6709010390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, 2,467 clinicians

Practice addresses (Care Compare)

877 W Faris Rd
Suite D
Greenville, SC 29605-4296
Phone (864) 455-6840

Hospital & facility affiliations

  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078
  • Prisma Health Oconee Memorial Hospital Hospital, Seneca, SC, CCN 420009
  • Prisma Health Patewood Hospital Hospital, Greenville, SC, CCN 420102
  • Prisma Health Greer Memorial Hospital Hospital, Spartanburg, SC, CCN 420033
  • Prisma Health Hillcrest Hospital Hospital, Simpsonville, SC, CCN 420037
  • Prisma Health North Greenville Ltach Long-term care hospital, Travelers Rest, SC, CCN 422008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35708SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Internal Medicine CurrentSince Jul 23, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 23, 2018 Accepting new patients

Locations

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

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

701 Grove Rd
Fl 5
Greenville, SC 29605
Phone (864) 455-4411

877 W Faris Rd
Ste D
Greenville, SC 29605
Phone (864) 455-9031

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

Interoperability endpoints

  • Direct secure messaging: mrappaport5859@direct.ghs.myhfn.org

Organizations & group practices 2

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 56

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1174963953",
    "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": "877 W FARIS RD STE D",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054296",
            "telephone_number": "864-455-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAPPAPORT",
        "first_name": "MAXIMILIEN",
        "middle_name": "JACOB",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "LL35708",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IN",
            "license": "02004827A",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "SC",
            "license": "35708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "357082",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.