NPIMap

Individual provider Active NPI

Stephanie Berlet-Dach

  • Obstetrics & Gynecology Physician
  • Greenville, SC
National Provider Identifier
1376539585
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
669 Issued in SC
Practice address
124 Verdae Blvd.
Suite 204
Greenville, SC 29607
Phone
(864) 271-9780
Fax
(864) 271-9785
NPI assigned
Sep 22, 2005
Last updated
Jun 16, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 669 SC Primary

Addresses

Primary practice location

124 Verdae Blvd.
Suite 204
Greenville, SC 29607

Mailing address

124 Verdae Blvd.
Suite 204
Greenville, SC 29607
Phone (864) 271-9780

Other identifiers 1

IdentifierTypeStateIssuer
006692MedicaidSC

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
I20040615000395 SC Practitioner - Obstetrics/Gynecology 8426032871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of North Texas HSC, College of Osteopathic Med, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1011 Tiger Blvd
Suite 100
Clemson, SC 29631-1401
Phone (864) 654-9053

125 Commonwealth Dr
Greenville, SC 29615-4812
Phone (864) 675-4000

135 Commonwealth Dr
Suite 300
Greenville, SC 29615-4860
Phone (864) 271-9780

317 Saint Francis Dr
Suite 220
Greenville, SC 29601-3976
Phone (864) 255-1901

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
669SCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Greenville Specialty Care LLC CurrentSince May 21, 2022 Accepting new patients
Bon Secours Medical Group Greenville Specialty Care LLC Obstetrics & Gynecology CurrentSince May 21, 2022 Accepting new patients
St Francis Physician Services Inc Obstetrics & Gynecology Past Accepting new patients
St Francis Hospital, Inc. Past Accepting new patients

Locations

1011 Tiger Blvd
Ste 100
Clemson, SC 29631
Phone (864) 382-4035

124 Verdae Blvd
Ste 204
Greenville, SC 29607
Phone (864) 271-9780

135 Commonwealth Dr
Ste 3
Greenville, SC 29615

213 Halton Rd
Greenville, SC 29607
Phone (864) 382-4000

317 Saint Francis Dr
Ste 220
Greenville, SC 29601
Phone (864) 255-1901

Interoperability endpoints

  • Direct secure messaging: sberletdach1149451@direct.bsmhealth.org

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1376539585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 VERDAE BLVD.",
            "address_2": "SUITE 204",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29607",
            "telephone_number": "864-271-9780",
            "fax_number": "864-271-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 VERDAE BLVD.",
            "address_2": "SUITE 204",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29607",
            "telephone_number": "864-271-9780",
            "fax_number": "864-271-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERLET-DACH",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006692",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.