Individual provider Active NPI

John David Konsek, MD

  • Surgery Physician
  • Greenwood, SC
National Provider Identifier
1639285083
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
21187 Issued in SC
Practice address
160 Academy Ave
Greenwood, SC 29646
Phone
(864) 223-8090
Fax
(864) 223-4026
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 21187 SC Primary

Addresses

Primary practice location

160 Academy Ave
Greenwood, SC 29646

Mailing address

160 Academy Ave
Greenwood, SC 29646
Phone (864) 223-8090

Other identifiers 1

IdentifierTypeStateIssuer
GP5280MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20091029000045 SC Practitioner - General Surgery 3971640640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Self Medical GroupGroup PAC ID 6002953916, 393 clinicians

Practice addresses (Care Compare)

1325 Spring St
Greenwood, SC 29646-3860
Phone (864) 725-4111

160 Academy Ave
Greenwood, SC 29646-3808
Phone (864) 223-8090

Hospital & facility affiliations

  • Self Regional Healthcare Hospital, Greenwood, SC, CCN 420071

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy37
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Self Medical Group Surgery Current Accepting new patients
Self Medical Group Surgery CurrentSince Oct 1, 2009 Accepting new patients
Self Medical Group CurrentSince Oct 1, 2009 Accepting new patients
Self Regional Healthcare Past Accepting new patients
Greenwood Surgical Assoc. Surgery Past Accepting new patients
Self Medical Group PastSince May 7, 2024 Accepting new patients

Locations

75 Remittance Dr
Dept 6764
Chicago, IL 60675

23013 Highway 76 E
Ste 100
Clinton, SC 29325
Phone (800) 233-5733

160 Academy Ave
Greenwood, SC 29646
Phone (864) 223-7809

22580 Highway 76 E
Ste 200
Laurens, SC 29360
Phone (864) 725-1480

2605 Kinard St
Ste 200
Newberry, SC 29108
Phone (803) 276-1866

Interoperability endpoints

  • Direct secure messaging: jkonsek127313@selfregional.direct-ci.net

Organizations & group practices 6

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 4

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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1639285083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-223-8090",
            "fax_number": "864-223-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 ACADEMY AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29646",
            "telephone_number": "864-223-8090",
            "fax_number": "864-223-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONSEK",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SC",
            "license": "21187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP5280",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

Verify at the official NPI Registry.