Individual provider Active NPI

Cathryn Aliceaacosta, MD

  • Family Medicine Physician
  • Cheraw, SC
National Provider Identifier
1295312130
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL85937 Issued in SC
Practice address
710 Chesterfield Hwy
Cheraw, SC 29520-7001
Phone
(843) 537-2171
NPI assigned
Mar 26, 2021
Last updated
Jun 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL85937 SC Primary

Addresses

Primary practice location

710 Chesterfield Hwy
Cheraw, SC 29520-7001

Mailing address

PO Box 809
Cheraw, SC 29520-0809

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
I20240917001148 SC Practitioner - Family Practice 2769884535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Loris Seacoast HospitalGroup PAC ID 9133394398, 57 clinicians

Practice addresses (Care Compare)

101 McLeod Health Blvd
Suite 201
Myrtle Beach, SC 29579-4477
Phone (843) 646-8001

3655 Mitchell St
Loris, SC 29569-2827
Phone (843) 716-7111

4000 Hwy 9 E
Little River, SC 29566-7833
Phone (843) 390-8100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LL85937SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Loris Seacoast Hospital CurrentSince Aug 1, 2024 Accepting new patients
McLeod Loris Seacoast Hospital CurrentSince Aug 1, 2024 Accepting new patients
Cheraw Family Medicine Family Medicine PastSince Mar 28, 2021 Accepting new patients
McLeod Loris Seacoast Hospital Past Accepting new patients

Locations

3655 Mitchell St
Loris, SC 29569
Phone (843) 716-7000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1295312130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295200809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207001",
            "telephone_number": "843-537-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALICEAACOSTA",
        "first_name": "CATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL85937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.