Individual provider Active NPI

Aqil Ebun Surka, MD

  • Pediatrics Physician
  • Spartanburg, SC
National Provider Identifier
1477529741
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
21965 Issued in SC
Practice address
249 N Grove Medical Park Dr Ste 100
Spartanburg, SC 29303-4227
Phone
(864) 582-8135
Fax
(864) 573-9757
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21965 SC
Pediatrics Physician 208000000X 21965 SC Primary

Addresses

Primary practice location

249 N Grove Medical Park Dr Ste 100
Spartanburg, SC 29303-4227

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Other identifiers 1

IdentifierTypeStateIssuer
219659MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asurka7220@direct.ghs.myhfn.org Direct

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
I20081017000396 SC Practitioner - Pediatric Medicine 2264590348 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21965SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group Pediatrics CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System Past Accepting new patients
Anmed Health Past Accepting new patients

Locations

2000 E Greenville St
Anderson, SC 29621
Phone (864) 512-1000

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604

315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550

719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000

249 North Grove Medical Park Dr
Ste 100
Spartanburg, SC 29303
Phone (864) 582-8135

1686 Skylyn Dr
Ste 201
Spartanburg, SC 29307
Phone (864) 542-1804

807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132

Interoperability endpoints

  • Direct secure messaging: asurka86709@direct.anmedhealth.net
  • Direct secure messaging: asurka7220@direct.ghs.myhfn.org

Organizations & group practices 4

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": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1477529741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 N GROVE MEDICAL PARK DR STE 100",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293034227",
            "telephone_number": "864-582-8135",
            "fax_number": "864-573-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURKA",
        "first_name": "AQIL",
        "middle_name": "EBUN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "21965",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "21965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219659",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asurka7220@direct.ghs.myhfn.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "asurka7220@direct.ghs.myhfn.org",
            "address_1": "249 N Grove Medical Park Dr Ste 100",
            "city": "Spartanburg",
            "state": "SC",
            "country_code": "US",
            "postal_code": "293034227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.