NPIMap

Individual provider Active NPI

Nelson Randolph Ploch, M.D.

  • Urology Physician
  • North Charleston, SC
National Provider Identifier
1205824489
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
17562 Issued in SC
Practice address
2890 Tricom Street
North Charleston, SC 29406-9171
Phone
(843) 797-6600
Fax
(843) 820-1440
NPI assigned
Oct 11, 2005
Last updated
Apr 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 17562 SC Primary

Addresses

Primary practice location

2890 Tricom Street
North Charleston, SC 29406-9171

Mailing address

2890 Tricom Street
North Charleston, SC 29406-9171
Phone (843) 797-6600

Other identifiers 3

IdentifierTypeStateIssuer
7026OtherSCMEDICARE GROUP
GP4871MedicaidSC
340013328OtherSCRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928001279 SC Practitioner - Urology 1153490925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Texas Tech University Health Science Center School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palmetto Adult and Childrens Urology PAGroup PAC ID 1254400021, 6 clinicians

Practice addresses (Care Compare)

2890 Tricom St
N Charleston, SC 29406-9171
Phone (843) 797-6600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.96 of 100Reported as group
Quality
65.18
Promoting interoperability
100
Improvement activities
40
Cost
81.34

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection18

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Adult and Childrens Urology PA Urology CurrentSince Sep 20, 2000 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

2890 Tricom St
North Charleston, SC 29406
Phone (803) 549-7122

104 Morgan Pl
Ste C
Summerville, SC 29485
Phone (843) 797-6600

5500 Front St
Ste 250
Summerville, SC 29486
Phone (843) 278-8474

302 Medical Park Dr
Ste 207
Walterboro, SC 29488
Phone (803) 536-5511

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.

Hospital & facility affiliations 6

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1205824489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 TRICOM STREET",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 TRICOM STREET",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069171",
            "telephone_number": "843-797-6600",
            "fax_number": "843-820-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOCH",
        "first_name": "NELSON",
        "middle_name": "RANDOLPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "17562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "7026",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4871",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340013328",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.