NPIMap

Individual provider Active NPI

Temujin Tom Chavez, M.D.

  • Infectious Disease Physician
  • Florence, SC
National Provider Identifier
1558323543
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
TL34011 Issued in SC
Practice address
805 Pamplico Hwy
Suite B-125
Florence, SC 29505-6047
Phone
(843) 674-6400
Fax
(843) 674-6410
NPI assigned
Apr 5, 2006
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X TL34011 SC Primary
Military Health Care Provider 171000000X 0101235352 VA

Addresses

Primary practice location

805 Pamplico Hwy
Suite B-125
Florence, SC 29505-6047

Mailing address

PO Box 11271
Belfast, ME 04915-4003

Other identifiers 1

IdentifierTypeStateIssuer
340116MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tchavez254649@direct.musc.edu Direct

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
I20110914000589 SC Practitioner - Infectious Disease 0547431017 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Perelman School of Med at the University of Pennsylvania, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505-6047

Hospital & facility affiliations

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

State licenses

LicenseStateTypeSpecialty
0101235352VAMDMilitary Health Care Provider
TL34011SCMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Family Care, Inc CurrentSince Mar 1, 2019 Accepting new patients
Carolina Family Care, Inc CurrentSince Mar 1, 2019 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Mar 1, 2015 Accepting new patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

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

300 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 234-6946

1925 Hoffmeyer Rd
Florence, SC 29501
Phone (843) 661-4390

805 Pamplico Hwy
Ste 300
Florence, SC 29505
Phone (843) 679-2760

805 Pamplico Hwy
Ste B125
Florence, SC 29505
Phone (843) 629-2605

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

Interoperability endpoints

  • Direct secure messaging: tchavez254649@direct.musc.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1558323543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11271",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "address_2": "SUITE B-125",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-674-6400",
            "fax_number": "843-674-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "TEMUJIN",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "SC",
            "license": "TL34011",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "VA",
            "license": "0101235352",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340116",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tchavez254649@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "805 Pamplico Hwy",
            "address_2": "Suite B-125",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.