NPIMap

Individual provider Active NPI

Sanjay Kumar, MD

  • Internal Medicine Physician
  • Walterboro, SC
National Provider Identifier
1275632309
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
164379 Issued in SC
Practice address
461 Spruce St
Walterboro, SC 29488-2766
Phone
(843) 549-4335
Fax
(843) 549-6502
NPI assigned
Sep 22, 2006
Last updated
Apr 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 164379 SC Primary
Nephrology Physician 207RN0300X 16437 SC

Addresses

Primary practice location

461 Spruce St
Walterboro, SC 29488-2766

Mailing address

461 Spruce St
Walterboro, SC 29488-2766
Phone (843) 549-4335

Other identifiers 1

IdentifierTypeStateIssuer
GP2719MedicaidSC

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
I20110118001233 SC Practitioner - NephrologyPractitioner - Internal Medicine 9436180775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolina Medical Center of Walterboro PAGroup PAC ID 3779514112, 2 clinicians

Practice addresses (Care Compare)

461 Spruce St
Walterboro, SC 29488-2766
Phone (843) 549-4335

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16437SCMDClinical Social Worker
164379SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Medical Center of Walterboro PA CurrentSince Jul 2, 2001 Accepting new patients

Locations

461 Spruce St
Walterboro, SC 29488
Phone (843) 549-4335

Organizations & group practices 1

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 10

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

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1275632309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 SPRUCE ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882766",
            "telephone_number": "843-549-4335",
            "fax_number": "843-549-6502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 SPRUCE ST",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294882766",
            "telephone_number": "843-549-4335",
            "fax_number": "843-549-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SANJAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "164379",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "SC",
            "license": "16437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2719",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walterboro, SC

Sources for this page

Verify at the official NPI Registry.