NPIMap

Individual provider Active NPI

Andrew Pavlina

  • Diagnostic Radiology Physician
  • Anderson, SC
National Provider Identifier
1629456587
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
85794 Issued in SC
Practice address
211 S Main St
Anderson, SC 29624-1620
Phone
(864) 226-0511
NPI assigned
May 12, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 85794 SC Primary

Addresses

Primary practice location

211 S Main St
Anderson, SC 29624-1620

Mailing address

211 S Main St
Anderson, SC 29624-1620

Other practice location 1

1 Medical Center Blvd
Winston Salem, NC 27157-2364
Phone (336) 716-2011

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
I20210909002042 SC Practitioner - Diagnostic Radiology 4880988740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic Radiology of Anderson PAGroup PAC ID 3173559945, 43 clinicians

Practice addresses (Care Compare)

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1000

Hospital & facility affiliations

  • Anmed Health Hospital, Anderson, SC, CCN 420027
  • Cannon Memorial Hospital Hospital, Pickens, SC, CCN 420011
  • St Francis-Downtown Hospital, Greenville, SC, CCN 420023
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic Radiology of Anderson, P.a. Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Piedmont Pathology Associates PA Current Accepting new patients

Locations

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

211 S Main St
Anderson, SC 29624
Phone (864) 512-2259

123 Wg Acker Dr
Pickens, SC 29671
Phone (864) 512-2465

Organizations & group practices 2

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 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1629456587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 S MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296241620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S MAIN ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296241620",
            "telephone_number": "864-226-0511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271572364",
            "country_code": "US",
            "telephone_number": "336-716-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLINA",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "85794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.