NPIMap

Individual provider Active NPI

Thomas Charles Dittrich, M.D.

  • Emergency Medicine Physician
  • Charleston, SC
National Provider Identifier
1407291990
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
39224 Issued in SC
Practice address
2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone
(518) 429-9295
NPI assigned
May 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 39224 SC Primary

Addresses

Primary practice location

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733

Mailing address

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-1037

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
I20160810001794 SC Practitioner - Emergency Medicine 4981902376 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Temple University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River Physicians Group, LLC 70 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

  • Bon Secours-St Francis Xavier Hospital Hospital, Charleston, SC, CCN 420065
  • Roper St Francis Hospital-Berkeley Inc Hospital, Summerville, SC, CCN 420110
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Mount Pleasant Hospital Hospital, Mount Pleasant, SC, CCN 420104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Physicians Group, LLC Emergency Medicine CurrentSince Jan 1, 2023 Accepting new patients
Roper Hospital Inc Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Sep 1, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital Emergency Medicine CurrentSince Sep 1, 2020 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Jul 8, 2016 Accepting new patients
Roper Hospital Inc. CurrentSince Sep 1, 2020 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Emergency Medicine CurrentSince Jul 8, 2016 Accepting new patients
Roper St. Francis Mount Pleasant Hospital Current Accepting new patients
Roper Hospital Inc Emergency Medicine Current Accepting new patients

Locations

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2435 Forest Dr
Columbia, SC 29204
Phone (770) 874-6859

730 Stony Landing Rd
Moncks Corner, SC 29461
Phone (843) 572-9211

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

7832 Rivers Ave
North Charleston, SC 29406
Phone (843) 824-8733

101 Sawmill Centre Dr
Summerville, SC 29483

100 Callen Blvd
Summerville, SC 29486
Phone (845) 529-3165

Interoperability endpoints

  • Direct secure messaging: tdittrich42251@bassett.direct-ci.net

Organizations & group practices 9

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 4

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": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1407291990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "843-402-1037",
            "fax_number": "843-402-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145733",
            "telephone_number": "518-429-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTRICH",
        "first_name": "THOMAS",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-09",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "39224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.