Individual provider Active NPI

Dimitrios Virvilis, MD

  • Vascular Surgery Physician
  • Columbia, SC
National Provider Identifier
1275795148
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
24090 Issued in MS
Practice address
3 Richland Medical Park Dr Ste 330
Columbia, SC 29203-6862
Phone
(803) 434-6889
NPI assigned
Jul 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 24090 MS Primary

Addresses

Primary practice location

3 Richland Medical Park Dr Ste 330
Columbia, SC 29203-6862

Mailing address

139 Bayerl Dr
Columbia, SC 29206-3167
Phone (631) 805-9542

Other practice location 1

1340 Broad Ave
Suite 220
Gulfport, MS 39501-2404
Phone (228) 864-0092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20220516001419 NY Practitioner - Vascular Surgery 1355651738 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (631) 376-3000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)21
Removal of tissue35
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC CurrentSince Aug 16, 2023 Accepting new patients
CHS Physician Partners, PC Current Accepting new patients
CHS Physician Partners, P.C CurrentSince Aug 16, 2023 Accepting new patients
St. Francis Hospital Past Accepting new patients

Locations

2200 Northern Blvd
Ste 210
Greenvale, NY 11548
Phone (516) 248-2422

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722

Interoperability endpoints

  • Direct secure messaging: dvirvilis147034@direct-chsli.net
  • FHIR API: https://api.platform.athenahealth.com/21626/brand/2/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1275795148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 BAYERL DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063167",
            "telephone_number": "631-805-9542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 RICHLAND MEDICAL PARK DR STE 330",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036862",
            "telephone_number": "803-434-6889"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Broad Ave",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395012404",
            "country_code": "US",
            "telephone_number": "228-864-0092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIRVILIS",
        "first_name": "DIMITRIOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-01",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MS",
            "license": "24090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.