Michael M Kassur, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

23670 Issued in SC

Practice address

2100 Charlie Hall Blvd
Charleston, SC 29414-5832

Phone

(843) 852-4100

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• South Carolina Dept of Mental Health Accounting Office

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Charleston, SC
  • NPI 1760596480
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD
• South Carolina Dept of Mental Health Accounting Office

  • Skilled Nursing Facility
  • Columbia, SC
  • NPI 1205888260
  NPD
• Ohio State University

  • Clinical Psychologist
  • Columbus, OH
  • NPI 1972561892
  NPD (past)
• Pinnacle Behavioral Health LLC

  • Psychiatry Physician
  • Columbus, OH
  • NPI 1609886506
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330473600000",
    "number": "1508876491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CHARLIE HALL BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145832",
            "telephone_number": "843-852-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSUR",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35.063424",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "23670",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.063424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0884655",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kassis Long Family Dentistry
• Raymond Kassis, DDS
• Tala Marie Kassm, D.O.
• Matthew J Kasson, MD
• Danuta Anna Kassur, MD
• Shawn Katalinas, OTR/L
• Lakshmi Pappu Katikaneni, MD
• Kostantinos Michael Katsanevakis, PHARMD
• Ward A Katsanis, MD
• Alexandra Katz

• Psychiatry Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.