NPIMap

Individual provider Active NPI

Andrew Charles Stubenrauch, MD

  • Diagnostic Radiology Physician
  • Greenville, SC
National Provider Identifier
1508360876
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
90689 Issued in SC
Practice address
1210 W Faris Rd
Greenville, SC 29605-4444
Phone
(864) 522-1800
Fax
(864) 522-1806
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2023-01154 NC
Diagnostic Radiology Physician 2085R0202X 90689 SC Primary

Addresses

Primary practice location

1210 W Faris Rd
Greenville, SC 29605-4444

Mailing address

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

Other practice location 1

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240729000443 SC Practitioner - Diagnostic Radiology 2961752811 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians
Leconte Radiology PCGroup PAC ID 1850373705, 31 clinicians

Practice addresses (Care Compare)

1210 W Faris Rd
Greenville, SC 29605-4444
Phone (864) 522-1800

1519 Marion St
Columbia, SC 29201-2910
Phone (803) 296-5954

5 Richland Medical Park Dr
Columbia, SC 29203-6863
Phone (803) 434-2168

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
90689SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Leconte Radiology PC Diagnostic Radiology CurrentSince Sep 1, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 30, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Sep 10, 2025 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jul 15, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Aug 8, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Sep 17, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Feb 9, 2026 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jul 15, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince Jul 15, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 29, 2024 Accepting new patients

Locations

5 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 434-2168

1519 Marion St
Columbia, SC 29201
Phone (803) 296-5513

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

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

Interoperability endpoints

  • Direct secure messaging: astubenrauch789831@direct.ghs.myhfn.org
  • Direct secure messaging: astubenrauch548115@direct.medicine.duke.edu

Organizations & group practices 10

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1508360876",
    "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": "1210 W FARIS RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054444",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 Erwin Rd",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277054699",
            "country_code": "US",
            "telephone_number": "919-684-8111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STUBENRAUCH",
        "first_name": "ANDREW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2023-01154",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "90689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.