Individual provider Active NPI

Daniel Kassaye Game, M. D.

  • Pulmonary Disease Physician
  • Charleston, SC
National Provider Identifier
1457322059
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
22070 Issued in SC
Practice address
1866 Raoul Wallenberg Blvd
Suite B
Charleston, SC 29407-3545
Phone
(843) 766-6646
Fax
(843) 766-6646
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 22070 SC Primary

Addresses

Primary practice location

1866 Raoul Wallenberg Blvd
Suite B
Charleston, SC 29407-3545

Mailing address

PO Box 80054
Charleston, SC 29416-0054
Phone (843) 766-6646

Other identifiers 2

IdentifierTypeStateIssuer
290013912OtherSCMEDICARE ID-TYPE UNSPECIFIED/MEDICARE(RAILROAD)
GP3435MedicaidSC

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
I20110217000614 SC Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 3577744960 Practice locations: Charleston, SC

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1866 Raoul Wallenberg Blvd
Suite B
Charleston, SC 29407-3545
Phone (843) 766-6646

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Diseases Care, P.a. Pulmonary Disease PastSince Sep 1, 2001 Accepting new patients

Organizations & group practices 1

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 2

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1457322059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80054",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294160054",
            "telephone_number": "843-766-6646",
            "fax_number": "843-766-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 RAOUL WALLENBERG BLVD",
            "address_2": "SUITE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294073545",
            "telephone_number": "843-766-6646",
            "fax_number": "843-766-6646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAME",
        "first_name": "DANIEL",
        "middle_name": "KASSAYE",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "22070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED/MEDICARE(RAILROAD)",
            "identifier": "290013912",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3435",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.