NPIMap

Individual provider Active NPI

Fred A Michael, MD

  • Family Medicine Physician
  • Charleston, SC
National Provider Identifier
1417065665
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
16758 Issued in SC
Practice address
171 Ashley Ave
Charleston, SC 29425-0001
Phone
(843) 792-6200
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16758 SC Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-0001

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
T10761MedicaidSC

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
I20060321000667 SC Practitioner - Family Practice 2567440878 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

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

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
79.17
Improvement activities
40
Cost
69.71

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16758SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians of SC, LLC CurrentSince Jan 29, 2024 Accepting new patients
Hampton Regional Medical Center CurrentSince Oct 1, 2014 Accepting new patients
Hampton Regional Medical Center Current Accepting new patients
Southeastern Hospitalist Services PC Family Medicine CurrentSince Jan 18, 2016 Accepting new patients
Roper Hospital, Inc Past Accepting new patients
Bon Secours St. Francis Xavier Hospital Inc. Past Accepting new patients
Fairfield Memorial Hospital Past 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

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

595 W Carolina Ave
Varnville, SC 29944
Phone (803) 943-1221

Organizations & group practices 7

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417065665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250001",
            "telephone_number": "843-792-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "FRED",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "16758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T10761",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.