NPIMap

Individual provider Active NPI

Ismail Mikdat Kabakus, M.D. PH.D.

  • Diagnostic Radiology Physician
  • Charleston, SC
National Provider Identifier
1548746803
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MMD.61251 Issued in SC
Practice address
96 Jonathan Lucas St
Charleston, SC 29425-8900
Phone
(843) 830-6729
NPI assigned
Jul 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MMD.61251 SC Primary

Addresses

Primary practice location

96 Jonathan Lucas St
Charleston, SC 29425-8900

Mailing address

169 Ashley Ave RM 202
Charleston, SC 29425-3147
Phone (843) 792-2396

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
I20210609001521 SC Practitioner - Diagnostic Radiology 2668726670 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

171 Ashley Ave
Charleston, SC 29425-8908
Phone (843) 792-1414

Hospital & facility affiliations

  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • Tidelands Georgetown Memorial Hospital Hospital, Georgetown, SC, CCN 420020
  • Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067
  • Trident Medical Center Hospital, Charleston, SC, CCN 420079
  • Conway Medical Center Hospital, Conway, SC, CCN 420049

Merit-based Incentive Payment System (MIPS)

Final score
79.02 of 100Reported as group
Quality
62.41
Promoting interoperability
99
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MMD.61251SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Associates of the Medical University of South Carol Diagnostic Radiology CurrentSince Jun 10, 2021 Accepting new patients
Musc Community Physicians Diagnostic Radiology Current Accepting new patients
Tidelands Health Market Common LLC CurrentSince Jan 1, 2026 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Jun 10, 2021 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2023 Accepting new patients
Tidelands and Medquest Joint Venture, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

169 Ashley Ave
Rm 202
Charleston, SC 29425
Phone (843) 792-0192

96 Jonathan Lucas St
Charleston, SC 29425
Phone (843) 792-3072

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1548746803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294253147",
            "telephone_number": "843-792-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 JONATHAN LUCAS ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258900",
            "telephone_number": "843-830-6729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABAKUS",
        "first_name": "ISMAIL",
        "middle_name": "MIKDAT",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "MMD.61251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.