NPIMap

Individual provider Active NPI

Iris Diana Ignacio, MD

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1265658264
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31057 Issued in SC
Practice address
1594 Freedom Blvd Ste 202
Florence, SC 29505-6046
Phone
(843) 644-9696
Fax
(843) 629-7082
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10713 ND
Family Medicine Physician 207Q00000X 31057 SC Primary

Addresses

Primary practice location

1594 Freedom Blvd Ste 202
Florence, SC 29505-6046

Mailing address

1594 Freedom Blvd Ste 202
Florence, SC 29505-6046
Phone (843) 644-9696

Other identifiers 2

IdentifierTypeStateIssuer
310577MedicaidSC
1265658264OtherNPI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address iignacio252991@direct.musc.edu Direct

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
I20080923000648 SC Practitioner - Family Practice 4183710619 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1594 Freedom Blvd
Florence, SC 29505-6046

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

  • Centerwell Home Health-Pee Dee Home health agency, Florence, SC, CCN 427854
  • Musc Health at Home by Bayada-Conway Home health agency, Conway, SC, CCN 427135
  • Amedisys Home Health of Conway Home health agency, Conway, SC, CCN 427112
  • Carolinas Home Health Home health agency, Florence, SC, CCN 427058
  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • CCN 420117 Hospital, CCN 420117
  • Musc Health Marion Medical Center Hospital, Mullins, SC, CCN 420055

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10713NDMDFamily Medicine Physician
31057SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Carolina Family Care, Inc Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1925 Hoffmeyer Rd
Florence, SC 29501
Phone (843) 661-4390

1594 Freedom Blvd
Ste 202
Florence, SC 29505
Phone (843) 644-9696

805 Pamplico Hwy
Ste 300
Florence, SC 29505
Phone (843) 679-2760

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

Interoperability endpoints

  • Direct secure messaging: iignacio252991@direct.musc.edu

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 and National Provider Directory roles.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1265658264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD STE 202",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-644-9696",
            "fax_number": "843-629-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 FREEDOM BLVD STE 202",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056046",
            "telephone_number": "843-644-9696",
            "fax_number": "843-629-7082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNACIO",
        "first_name": "IRIS",
        "middle_name": "DIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "10713",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "31057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310577",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265658264",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "iignacio252991@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1594 Freedom Blvd Ste 202",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.