Allen E Pendarvis Jr., M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

32696 Issued in SC

Practice address

1064 Gardner Rd Ste 112
Charleston, SC 29407-5768

Phone

(843) 723-3441

Fax

(843) 805-4040

NPI assigned

Jun 14, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

Medical University of South Carolina College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates of Charleston PAGroup PAC ID 4082607361, 38 clinicians

Bon Secours St Francis Xavier Hospital IncGroup PAC ID 8325008717, 202 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Roper Hospital Hospital, Charleston, SC, CCN 420087
• Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104
• Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Anesthesia Associates of Charleston, P.a.

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1396776670
  Medicare reassignment Care Compare group NPD
• Bon Secours St Francis Xavier Hospital, Inc.

  • Cardiovascular Disease Physician
  • Charleston, SC
  • NPI 1740502822
  Medicare reassignment Care Compare group NPD
• Bon Secours St. Francis Xavier Hospital, Inc.

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1871035956
  NPD
• Bon Secours St. Francis Xavier Hospital, Inc.

  • Pediatrics Physician
  • Charleston, SC
  • NPI 1982583068
  NPD
• Anesthesia Associates of Charleston, P.a.

  • Non-Pharmacy Dispensing Site
  • Mt Pleasant, SC
  • NPI 1629693668
  NPD (past)

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

• Roper Hospital, Inc

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1962472860
  Care Compare affiliation
• Roper St Francis Hospital-Berkeley Inc.

  • General Acute Care Hospital
  • Summerville, SC
  • NPI 1336603646
  Care Compare affiliation
• Roper St. Francis Mount Pleasant Hospital

  • General Acute Care Hospital
  • Mt Pleasant, SC
  • NPI 1255645644
  Care Compare affiliation

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714867200000",
    "number": "1265753248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 GARDNER RD STE 112",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 GARDNER RD STE 112",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294075768",
            "telephone_number": "843-723-3441",
            "fax_number": "843-805-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-1436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDARVIS",
        "first_name": "ALLEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "32696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326962",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.