NPIMap

Individual provider Active NPI

Michael Charles Mareska, M.D.

  • Neurology Physician
  • Columbia, SC
National Provider Identifier
1538130778
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
31222 Issued in SC
Practice address
1333 Taylor St
Suite 1C
Columbia, SC 29201-2923
Phone
(803) 254-6391
Fax
(803) 799-0682
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 0101236270 VA
Neurology Physician 2084N0400X 31222 SC Primary

Addresses

Primary practice location

1333 Taylor St
Suite 1C
Columbia, SC 29201-2923

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 2

IdentifierTypeStateIssuer
312227MedicaidSC
010074207MedicaidVA

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
I20081008000745 SC Practitioner - Neurology 5092791335 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Cincinnati College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

1333 Taylor St
Suite 1C
Columbia, SC 29201-2944
Phone (803) 254-6391

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31222SCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Tuomey CurrentSince Jan 1, 2021 Accepting new patients
Prisma Health Tuomey CurrentSince Jan 1, 2021 Accepting new patients
Palmetto Health - University of South Carolina Medical Group CurrentSince Jun 3, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Neurology Current Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Jun 3, 2019 Accepting new patients
Henrico Doctors Neurology Associates LLC Neurology PastSince Oct 1, 2015 Accepting new patients
Neurological Associates, Inc. Neurology PastSince Feb 17, 1993 Accepting new patients

Locations

1333 Taylor St
Ste 1B
Columbia, SC 29201
Phone (803) 254-6391

1333 Taylor St
Ste 1C
Columbia, SC 29201
Phone (803) 254-6391

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

1301 Taylor St
Ste 7A
Columbia, SC 29201
Phone (803) 254-6391

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • Direct secure messaging: mmareska381830@direct.ghs.myhfn.org

Organizations & group practices 7

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 11

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1538130778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 TAYLOR ST",
            "address_2": "SUITE 1C",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012923",
            "telephone_number": "803-254-6391",
            "fax_number": "803-799-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARESKA",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "VA",
            "license": "0101236270",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "31222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312227",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010074207",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.