Individual provider Active NPI

Maritere Nazario, M.D.

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1205286036
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
39730 Issued in SC
Practice address
169 Ashley Ave
Room 202 Main Hospital MSC 333
Charleston, SC 29425-8905
Phone
(843) 792-8972
NPI assigned
Jun 13, 2016
Last updated
Jul 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL39730 SC
Pediatrics Physician 208000000X 39730 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Room 202 Main Hospital MSC 333
Charleston, SC 29425-8905

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

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
I20190812001013 SC Practitioner - Pediatric Medicine 8921386046 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 13, 2019 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 13, 2019 Accepting new patients

Locations

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

2070 Northbrook Blvd
Ste A16
North Charleston, SC 29406
Phone (843) 797-0416

Interoperability endpoints

  • Direct secure messaging: mnazario76171@direct.musc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1205286036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL MSC 333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIO",
        "first_name": "MARITERE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL39730",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "39730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.