Individual provider Active NPI

Mavinder Guram

  • Dermatology Physician
  • Columbia, SC
National Provider Identifier
1235768797
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD91657 Issued in SC
Practice address
3600 Forest Dr Ste 400
Columbia, SC 29204-4057
Phone
(803) 779-7316
NPI assigned
Apr 6, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD91657 SC Primary

Addresses

Primary practice location

3600 Forest Dr Ste 400
Columbia, SC 29204-4057

Mailing address

141 Country Place CT
Columbia, SC 29212-0911
Phone (803) 528-1934

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
I20240910000232 SC Practitioner - Dermatology 3375965023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CSC Acquisition, LLCGroup PAC ID 2860389160, 16 clinicians

Practice addresses (Care Compare)

3600 Forest Dr
Suite 400
Columbia, SC 29204-4057
Phone 8037797316205

Merit-based Incentive Payment System (MIPS)

Final score
87.55 of 100Reported as group
Quality
90
Promoting interoperability
92
Improvement activities
40
Cost
75.16

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision26
Removal of skin lesions1952
Removal or shaving of skin growth1-10
Skin biopsy557

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD91657SCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CSC Acquisition, LLC Dermatology CurrentSince Aug 1, 2024 Accepting new patients
CSC Acquisition, LLC Dermatology Current Accepting new patients
CSC Acquisition, LLC Dermatology CurrentSince Aug 1, 2024 Accepting new patients

Locations

1205 Lyttleton St
Camden, SC 29020
Phone (803) 432-5783

7039 Saint Andrews Rd
Columbia, SC 29212
Phone (803) 749-0097

3600 Forest Dr
Ste 400
Columbia, SC 29204
Phone (803) 779-7316

3600 Forest Dr
Columbia, SC 29204
Phone (803) 414-1999

448 Old Cherokee Rd
Lexington, SC 29072
Phone (803) 520-5800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1235768797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 COUNTRY PLACE CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292120911",
            "telephone_number": "803-528-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FOREST DR STE 400",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044057",
            "telephone_number": "803-779-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURAM",
        "first_name": "MAVINDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "MD91657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.