NPIMap

Individual provider Active NPI

Jose R Frialde, MD

  • Internal Medicine Physician
  • Anderson, SC
National Provider Identifier
1265482269
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
26899 Issued in SC
Practice address
1 Spring Back Way
Anderson, SC 29621-2676
Phone
(864) 716-2647
Fax
(864) 332-8269
NPI assigned
May 11, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 26899 SC Primary

Addresses

Primary practice location

1 Spring Back Way
Anderson, SC 29621-2676

Mailing address

1 Spring Back Way
Anderson, SC 29621-2676
Phone (864) 716-2647

Other identifiers 2

IdentifierTypeStateIssuer
G96592MedicaidSC
GP4342MedicaidSC

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
I20060117000253 SC Practitioner - Internal Medicine 8729002837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Spring Back Way
Anderson, SC 29621-2676
Phone (864) 716-2647

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 28, 2011 Accepting new patients
Medical Associates of Anderson,PC Internal Medicine CurrentSince Apr 10, 2006 Accepting new patients
South Carolina Dept of Mental Health Accounting Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Jun 28, 2011 Accepting new patients

Locations

1 Spring Back Way
Anderson, SC 29621
Phone (864) 512-2830

130 Highway 252
Anderson, SC 29621
Phone (864) 231-2600

4605 Belton Hwy
Anderson, SC 29621
Phone (803) 898-8461

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

Organizations & group practices 4

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 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1265482269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SPRING BACK WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212676",
            "telephone_number": "864-716-2647",
            "fax_number": "864-332-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPRING BACK WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212676",
            "telephone_number": "864-716-2647",
            "fax_number": "864-332-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIALDE",
        "first_name": "JOSE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "26899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G96592",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4342",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.