Individual provider Active NPI

Anthony Huub De Haas, MD

  • Surgery Physician
  • Pawleys Island, SC
National Provider Identifier
1447296124
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
20905 Issued in SC
Practice address
14490 Ocean Hwy
Pawleys Island, SC 29585-9998
Phone
(843) 545-8850
Fax
(843) 545-5081
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 20905 SC Primary

Addresses

Primary practice location

14490 Ocean Hwy
Pawleys Island, SC 29585-9998

Mailing address

14490 Ocean Hwy
Pawleys Island, SC 29585-9998
Phone (843) 545-8850

Other practice location 1

2361 Cypress Cir
Conway, SC 29526-8921
Phone (843) 347-7291

Other identifiers 1

IdentifierTypeStateIssuer
T49276MedicaidSC

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
I20100602000759 SC Practitioner - General SurgeryPractitioner - Vascular Surgery 6800925777 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
Brody School of Medicine at East Carolina University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital IncGroup PAC ID 7113839606, 127 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7112

Hospital & facility affiliations

  • Conway Medical Center Hospital, Conway, SC, CCN 420049

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20905SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group Surgery CurrentSince Jan 1, 2023 Accepting new patients
Self Medical Group Surgery Current Accepting new patients
McLeod Physician Associates II CurrentSince Oct 7, 2022 Accepting new patients
McLeod Physician Associates II CurrentSince Oct 7, 2022 Accepting new patients
Conway Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
McLeod Physician Associates II Surgery Current Accepting new patients
Self Medical Group CurrentSince Jan 1, 2023 Accepting new patients
Conway Hospital, Inc. CurrentSince Sep 1, 2023 Accepting new patients
McLeod Physician Associates II Past Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

394 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-8050

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

2361 Cypress Cir
Conway, SC 29526
Phone (843) 234-8600

705 N 8th Ave
Ste 2B
Dillon, SC 29536
Phone (843) 841-3846

705 N Ave
1B
Dillon, SC 29536
Phone (843) 841-3517

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

160 Academy Ave
Greenwood, SC 29646
Phone (864) 223-7809

50 E Hospital St
Ste 4
Manning, SC 29102
Phone (803) 435-2822

50 E Hospital St
Ste 4A
Manning, SC 29102
Phone (803) 433-0797

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: adehaas63847@selfregional.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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1447296124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14490 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295859998",
            "telephone_number": "843-545-8850",
            "fax_number": "843-545-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14490 OCEAN HWY",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295859998",
            "telephone_number": "843-545-8850",
            "fax_number": "843-545-5081"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2361 Cypress Cir",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295268921",
            "country_code": "US",
            "telephone_number": "843-347-7291",
            "fax_number": "843-347-0139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE HAAS",
        "first_name": "ANTHONY",
        "middle_name": "HUUB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "20905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T49276",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawleys Island, SC

Sources for this page

Verify at the official NPI Registry.