Organization Active NPI

Medical Associates of Anderson,PC

  • Internal Medicine Physician
  • Anderson, SC
National Provider Identifier
1598715518
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL ASSOCIATES OF ANDERSON,PC
Practice address
1 Spring Back Way
Anderson, SC 29621-2676
Phone
(864) 716-2647
Fax
(864) 332-8269
NPI assigned
May 11, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
Jose FrialdeNPI 1265482269
Title
MD
Phone
(864) 716-2647

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

1 Spring Back Way
Anderson, SC 29621-2676

Mailing address

1 Spring Back Way
Anderson, SC 29621-2676
Phone (864) 716-2647

Other identifiers 1

IdentifierTypeStateIssuer
GP4342MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060410000512 SC Part B Supplier - Clinic/Group Practice 6204845803 Receives reassigned benefits from 1 practitioner
Practice locations: Anderson, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1598715518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SPRING BACK WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212676",
            "telephone_number": "864-716-2647",
            "fax_number": "864-332-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPRING BACK WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296212676",
            "telephone_number": "864-716-2647",
            "fax_number": "864-332-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF ANDERSON,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "FRIALDE",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "864-716-2647"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4342",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.