Dana Bettina Pournaras, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

TL35193 Issued in SC

Practice address

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Phone

(843) 497-5929

Fax

(843) 839-4448

NPI assigned

Jul 8, 2009

Last updated

Nov 13, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dana Bettina Polydoropoulos Former name

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

Specialty

Internal Medicine

Education

University of Southern California Keck School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Southeastern Hospitalist Services PC

  • Hospitalist Physician
  • Myrtle Beach, SC
  • NPI 1003280108

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Healogics Specialty Physicians of South Carolina, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Myrtle Beach, SC
  • NPI 1033531850

  Internal Medicine

  Medicare reassignment NPD
• Healogics Specialty Physicians of South Carolina, LLC

  dba Upstate Wound Care by Healogics

  • Clinic/Center
  • Spartanburg, SC
  • NPI 1023677945
  NPD
• Medicos, P.a.

  • Internal Medicine Physician
  • North Myrtle Beach, SC
  • NPI 1548024540
  NPD (past)

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

• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1205065539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 OLEANDER DR",
            "address_2": "SUITE 103",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775741",
            "telephone_number": "843-497-5929",
            "fax_number": "843-839-4448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607",
            "telephone_number": "843-497-5929",
            "fax_number": "843-839-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POURNARAS",
        "first_name": "DANA",
        "middle_name": "BETTINA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "TL35193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351933",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "TL35193",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANA",
            "last_name": "POLYDOROPOULOS",
            "middle_name": "BETTINA",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Poster, LMT
• Poston Counseling Services LLC (Counselor)
• Catherine Evans Poston, PA-C
• Samantha Poston, LPC
• Robert Lee Poulos Jr., PHARMD.
• Vasilios Pournaras, DMD
• Azhane Powell, LISW
• Jessica Lynne Powell
• Lacey Powell
• Power Cutz Barber Shop LLC

• Internal Medicine Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.