Active NPI
Sameer Mishra
- Emergency Medicine Physician
- Greenville, SC
National Provider Identifier
1578127882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 89501
- Practice address
- 701 Grove Rd FL 1
Greenville, SC 29605-4210 - Phone
- (864) 455-7899
- Fax
- (864) 455-5474
- NPI assigned
- Apr 23, 2019
- Last updated
- Jul 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Emergency Medicine Physician | 207P00000X | 89501 | SC | Primary |
Addresses
Primary practice location
701 Grove Rd FL 1
Greenville, SC 29605-4210
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other practice location 1
5246 Brittany Dr
Baton Rouge, LA 70808-9136
Phone (404) 509-3563
Other practice location 2
420 E Superior St
Chicago, IL 60611-4494
Phone (312) 503-8649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Morehouse School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
677 Church Nest
Marietta, GA 30060-1101
Phone (770) 793-5000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.33 of 100
- Quality
- 75.48
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.29
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bortolazzo Group, LLC | Emergency Medicine | Current | Accepting new patients |
Locations
3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752
677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435
5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468
Interoperability endpoints
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
- smishra1653652@direct.ochsner.org
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Austell, GA
- NPI 1801965082
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Wellstar Cobb Hospital
- General Acute Care Hospital
- Austell, GA
- NPI 1467420448
-
dba Wellstar Douglas Hospital
- General Acute Care Hospital
- Douglasville, GA
- NPI 1649247974
-
dba Wellstar Paulding Hospital
- General Acute Care Hospital
- Hiram, GA
- NPI 1457329435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1578127882",
"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": "701 GROVE RD FL 1",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054210",
"telephone_number": "864-455-7899",
"fax_number": "864-455-5474"
}
],
"practiceLocations": [
{
"address_1": "5246 Brittany Dr",
"address_purpose": "LOCATION",
"city": "Baton Rouge",
"state": "LA",
"postal_code": "708089136",
"country_code": "US",
"telephone_number": "404-509-3563",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "420 E Superior St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606114494",
"country_code": "US",
"telephone_number": "312-503-8649",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MISHRA",
"first_name": "SAMEER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-23",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "89501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.