NPIMap

Individual provider Active NPI

Naresh Mullaguri, M.D.

  • Neurocritical Care Physician
  • Greenville, SC
National Provider Identifier
1275973661
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurocritical Care PhysicianTaxonomy code 2084A2900X
License
84022 Issued in SC
Practice address
200 Patewood Dr Ste B350
Greenville, SC 29615-6337
Phone
(864) 454-4500
Fax
(864) 454-4505
NPI assigned
Jun 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X MD84022 SC
Neurocritical Care Physician 2084A2900X 84022 SC Primary

Addresses

Primary practice location

200 Patewood Dr Ste B350
Greenville, SC 29615-6337

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8614

Other practice location 1

1 Hospital Dr
Columbia, MO 65201-5276
Phone (573) 882-1515

Other practice location 2

9500 Euclid Ave
Cleveland, OH 44195-5276
Phone (800) 223-2273

Other identifiers 1

IdentifierTypeStateIssuer
2013021067OtherMOMISSOURI TEMPORARY LICENSE NUMBER

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
I20200727003472 SC Practitioner - NeurologyPractitioner - Critical Care (Intensivists) 8224263629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Critical Care (Intensivists)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Patewood Dr
Suite B350
Greenville, SC 29615-6337
Phone (864) 454-4500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD84022SCMDVascular Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System General Acute Care Hospital Current Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 13, 2020 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 13, 2020 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

200 Patewood Dr
Ste B350
Greenville, SC 29615
Phone (864) 454-4500

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: nmullaguri147401@direct.metrohealth.org

Organizations & group practices 3

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 49

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

View all 49

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1275973661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR STE B350",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156337",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652015276",
            "country_code": "US",
            "telephone_number": "573-882-1515",
            "fax_number": "573-884-0070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9500 Euclid Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441955276",
            "country_code": "US",
            "telephone_number": "800-223-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLAGURI",
        "first_name": "NARESH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-28",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "SC",
            "license": "MD84022",
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "SC",
            "license": "84022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI TEMPORARY LICENSE NUMBER",
            "identifier": "2013021067",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.