Individual provider Active NPI

Kevin U Duque-Diaz, MD

  • General Practice Physician
  • Cheraw, SC
National Provider Identifier
1619679933
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2006-00007 Issued in NC
Practice address
710 Chesterfield Hwy
Cheraw, SC 29520-7001
Phone
(843) 537-2171
NPI assigned
Mar 20, 2023
Last updated
Jul 21, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2026-00007 NC
General Practice Physician 208D00000X 2006-00007 NC Primary
Hospitalist Physician 208M00000X 90042 SC

Addresses

Primary practice location

710 Chesterfield Hwy
Cheraw, SC 29520-7001

Mailing address

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 537-2171

Other practice location 1

129 N Washington St
Sumter, SC 29150-4949
Phone (803) 774-9680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260609000184 NC Practitioner - General Practice 4981066172 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, shared by 2 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

129 N Washington St
Sumter, SC 29150-4949
Phone (803) 774-9680

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2026-00007NCMDFamily Medicine Physician
2006-00007NCMDGeneral Practice Physician

Interoperability endpoints

  • Direct secure messaging: kduquediaz83624@directmcleodehealth.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.

Hospital & facility affiliations 1

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1619679933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "843-537-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207001",
            "telephone_number": "843-537-2171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "129 N Washington St",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291504949",
            "country_code": "US",
            "telephone_number": "803-774-9680",
            "fax_number": "803-434-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUQUE-DIAZ",
        "first_name": "KEVIN",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-20",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2026-00007",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2006-00007",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "SC",
            "license": "90042",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

Verify at the official NPI Registry.