NPIMap

Individual provider Active NPI

Macdonald Mayes Dubose, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Sumter, SC
National Provider Identifier
1265418164
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
22541 Issued in SC
Practice address
244 Church St
Sumter, SC 29150-4256
Phone
(803) 775-1001
Fax
(803) 774-1012
NPI assigned
Dec 22, 2005
Last updated
May 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 22541 SC Primary

Addresses

Primary practice location

244 Church St
Sumter, SC 29150-4256

Mailing address

244 Church St
Sumter, SC 29150-4256
Phone (803) 775-1001

Other practice location 1

1527 Urbana Rd
Summerton, SC 29148-8929
Phone (803) 485-2317

Other identifiers 1

IdentifierTypeStateIssuer
225412MedicaidSC

Other names 1

  • M Mayes Dubose Professional name

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
I20050810000444 SC Practitioner - Family PracticePractitioner - Geriatric Medicine 3870574288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of South Carolina School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Geriatric Specialists, LLCGroup PAC ID 2163693532, 5 clinicians

Practice addresses (Care Compare)

244 Church St
Sumter, SC 29150-4256
Phone (803) 775-1001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Geriatric Specialists, LLC CurrentSince Apr 12, 2011 Accepting new patients
Geriatric Practitioner Solutions, Inc. PastSince Jan 20, 2014 Accepting new patients
Internal Medical Associates, PA PastSince Apr 12, 2011 Accepting new patients
Prisma Health Medical Group-Midlands Past Accepting new patients
Prescriptions, Inc PastSince Mar 11, 2025 Accepting new patients

Locations

244 Church St
Sumter, SC 29150
Phone (803) 775-1001

Interoperability endpoints

  • Direct secure messaging: carolinageriatricspecialists@ppdxdirect.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
NHC Healthcare, SumterSumter, SC, CCN 425109 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2010
Jul 15, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1265418164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 CHURCH ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504256",
            "telephone_number": "803-775-1001",
            "fax_number": "803-774-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 CHURCH ST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291504256",
            "telephone_number": "803-775-1001",
            "fax_number": "803-774-1012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1527 Urbana Rd",
            "address_purpose": "LOCATION",
            "city": "Summerton",
            "state": "SC",
            "postal_code": "291488929",
            "country_code": "US",
            "telephone_number": "803-485-2317",
            "fax_number": "803-485-6066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "MACDONALD",
        "middle_name": "MAYES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "22541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225412",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "M",
            "last_name": "DUBOSE",
            "middle_name": "MAYES",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Sumter, SC

Sources for this page

Verify at the official NPI Registry.