Individual provider Active NPI

Elliot Seth Stolerman, M.D.

  • Clinical Genetics (M.D.) Physician
  • North Charleston, SC
National Provider Identifier
1457414161
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
36225 Issued in SC
Practice address
3520 W Montague Ave Ste 104
North Charleston, SC 29418-6083
Phone
(843) 746-1001
Fax
(843) 735-5097
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 56369 GA
Clinical Genetics (M.D.) Physician 207SG0201X 214201 MA
Clinical Genetics (M.D.) Physician 207SG0201X 36225 SC Primary

Addresses

Primary practice location

3520 W Montague Ave Ste 104
North Charleston, SC 29418-6083

Mailing address

101 Gregor Mendel Cir
Greenwood, SC 29646-2316
Phone (864) 941-8100

Other practice location 1

14 Edgewood Dr
Greenville, SC 29605-4246
Phone (864) 941-8100

Other identifiers 1

IdentifierTypeStateIssuer
362253MedicaidSC

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
I20131023000451 SC Practitioner - Internal MedicinePractitioner - Medical Genetics and Genomics 1850446378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Medical Genetics and Genomics
Education
State University of New York Downstate Medical Center, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greenwood Genetic Center LabGroup PAC ID 9830097039, 9 clinicians

Practice addresses (Care Compare)

14 Edgewood Dr
Greenville, SC 29605-4246
Phone (864) 250-7944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
56369GAMDInternal Medicine Physician
214201MAMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwood Genetics Center, Inc. Clinical Genetics (M.D.) CurrentSince Sep 3, 2013 Accepting new patients
Greenwood Genetic Center Lab CurrentSince Sep 3, 2013 Accepting new patients
Cooperative Healthcare Services Inc Internal Medicine Past Accepting new patients

Locations

14 Edgewood Dr
Greenville, SC 29605
Phone (864) 232-1803

101 Gregor Mendel Cir
Greenwood, SC 29646
Phone (864) 941-8100

3520 W Montague Ave
Ste 104
North Charleston, SC 29418
Phone (843) 746-1001

Interoperability endpoints

  • Direct secure messaging: estolerman473658@direct.musc.edu

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1457414161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 GREGOR MENDEL CIR",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296462316",
            "telephone_number": "864-941-8100",
            "fax_number": "864-941-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 W MONTAGUE AVE STE 104",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294186083",
            "telephone_number": "843-746-1001",
            "fax_number": "843-735-5097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Edgewood Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054246",
            "country_code": "US",
            "telephone_number": "864-941-8100",
            "fax_number": "864-941-8114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOLERMAN",
        "first_name": "ELLIOT",
        "middle_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "56369",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "MA",
            "license": "214201",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "SC",
            "license": "36225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362253",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.