Gerald Richard Fortuna, MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

25639 Issued in SC

Practice address

2728 Sunset Blvd Ste 400
West Columbia, SC 29169-4872

Phone

(803) 936-7095

Fax

(803) 936-7908

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX, SC2 enrollments

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 2

Specialty

Vascular Surgery

Education

University of South Carolina School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Vascular and Vein Center PAGroup PAC ID 4981660479, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trident Medical Center Hospital, Charleston, SC, CCN 420079
• Grand Strand Regional Medical Center Hospital, Myrtle Beach, SC, CCN 420085
• McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

Merit-based Incentive Payment System (MIPS)

Final score

84.09 of 100Reported as group

Quality

68.87

Promoting interoperability

100

Improvement activities

40

Cost

78.11

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AHDFBA

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.

• Coastal Vascular & Vein Center, LLC

  • Vascular Surgery Physician
  • Charleston, SC
  • NPI 1023157575
  Medicare reassignment Care Compare group NPD
• Coastal Vascular and Vein Institute LLC

  dba Coastal Vascular and Vein Center

  • Ambulatory Surgical Clinic/Center
  • Summerville, SC
  • NPI 1578259750

  Vascular Surgery

  Medicare reassignment NPD
• Acclaim Physician Group, Inc

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1780076562
  Medicare reassignment NPD
• Ut Physicians - Trauma Services

  • Trauma Surgery Physician
  • Houston, TX
  • NPI 1588965131
  Medicare reassignment NPD
• University of Cincinnati Surgeons-Trauma, LLC

  • Trauma Surgery Physician
  • Cincinnati, OH
  • NPI 1518938471
  NPD (past)

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

• Grand Strand Regional Medical Center LLC

  dba Grand Strand Medical Center

  • General Acute Care Hospital
  • Myrlte Beach, SC
  • NPI 1083668669
  Care Compare affiliation
• McLeod Loris Seacoast Hospital

  dba Loris Community Hospital

  • General Acute Care Hospital
  • Loris, SC
  • NPI 1306123344
  Care Compare affiliation
• Trident Medical Center, LLC

  dba HCA Healthcare Trident Hospital

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1366496937
  Care Compare affiliation

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1447479829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 400",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694872",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTUNA",
        "first_name": "GERALD",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2016023683",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MO",
            "license": "2016023683",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MO",
            "license": "2016023683",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "25639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447479829",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gfortuna115602@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Foothold Counseling, LLC
• Jason M Forche, CRNA
• Ashley Ford, PTA
• Joshay Ford
• William Forsyth, RPH
• Natalie S. R. Fouty, MFT
• Brett Fowler, M.D.
• Teresa Fowler, MD
• Tammie Fowles, LISW-CP
• Chad Byron Fox, AU.D.

• Vascular Surgery Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Vascular Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.