Individual provider Active NPI

Sofia Goyonaga-Calatayud, MD

  • Pediatrics Physician
  • Charleston, SC
National Provider Identifier
1285319293
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
LL90123 Issued in SC
Practice address
10 McClennan Banks Dr
Charleston, SC 29401-1164
Phone
(843) 792-8972
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X LL90123 SC Primary

Addresses

Primary practice location

10 McClennan Banks Dr
Charleston, SC 29401-1164

Mailing address

10 McClennan Banks Dr # 915
Charleston, SC 29401-1164
Phone (843) 792-8972

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240108003592 SC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 9436500170

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1285319293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MCCLENNAN BANKS DR # 915",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011164",
            "telephone_number": "843-792-8972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MCCLENNAN BANKS DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294011164",
            "telephone_number": "843-792-8972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOYONAGA-CALATAYUD",
        "first_name": "SOFIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "LL90123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.