Individual provider Active NPI

Eliza Agrest Varadi, MD

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1255535191
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL29944 Issued in SC
Practice address
452 Folly Rd
Charleston, SC 29412-2641
Phone
(843) 795-3344
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL29944 SC Primary

Addresses

Primary practice location

452 Folly Rd
Charleston, SC 29412-2641

Mailing address

452 Folly Rd
Charleston, SC 29412-2641
Phone (843) 367-7379

Other practice location 1

354 Folly Rd
Suite #5
Charleston, SC 29412-2594
Phone (843) 367-7379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL29944SCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pelican Pediatrics LLC Pediatrics Current Accepting new patients
Bon Secours St. Francis Xavier Hospital Inc. Past Accepting new patients

Locations

452 Folly Rd
Charleston, SC 29412
Phone (843) 532-2816

452 Folly Rd
Unit A
Charleston, SC 29412

354 Folly Rd
Ste 5
Charleston, SC 29412
Phone (843) 225-2374

Interoperability endpoints

  • Direct secure messaging: evaradi5@ppl-sc.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1255535191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122641",
            "telephone_number": "843-367-7379",
            "fax_number": "843-795-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122641",
            "telephone_number": "843-795-3344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "354 Folly Rd",
            "address_2": "Suite #5",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294122594",
            "country_code": "US",
            "telephone_number": "843-367-7379",
            "fax_number": "843-795-3143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARADI",
        "first_name": "ELIZA",
        "middle_name": "AGREST",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL29944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.