Organization Active NPI

Seaport Plastic Surgery PC

  • Plastic Surgery Physician
  • Savannah, GA
National Provider Identifier
1407549959
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
SEAPORT PLASTIC SURGERY PC
Practice address
2280 E Victory Dr Ste C
Savannah, GA 31404-3957
Phone
(912) 468-5464
NPI assigned
May 31, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Matthew D McLeod, MDNPI 1699933093
Title
Owner
Phone
(912) 468-5464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

2280 E Victory Dr Ste C
Savannah, GA 31404-3957

Mailing address

2280 E Victory Dr Ste C
Savannah, GA 31404-3957
Phone (912) 468-5464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240203000370 GA Part B Supplier - Clinic/Group Practice 6800239146 Receives reassigned benefits from 1 practitioner
Practice locations: Savannah, GA

National Provider Directory

National Provider Directory

Locations

2280 E Victory Dr
Ste C
Savannah, GA 31404
Phone (912) 468-5464

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1407549959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 E VICTORY DR STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314043957",
            "telephone_number": "912-468-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 E VICTORY DR STE C",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314043957",
            "telephone_number": "912-468-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEAPORT PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-02-07",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-468-5464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.