Active NPI
Edifel N Macatuno, M.D.
- Pediatric Adolescent Medicine Physician
- Spartanburg, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 23575
- Practice address
- 101 E Wood St
Spartanburg, SC 29303-3040 - Phone
- (864) 560-6287
- Fax
- (864) 560-7091
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | M23575 | SC | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 23575 | SC | Primary |
Addresses
Primary practice location
101 E Wood St
Spartanburg, SC 29303-3040
Mailing address
PO Box 743070
Atlanta, GA 30374-3070
Phone (864) 560-4304
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SCC5085019 | Other | SC | MEDICARE PIN |
| SCC508H895 | Other | SC | MEDICARE PIN |
| 235757 | Medicaid | SC | |
| SCC508J577 | Other | SC | MEDICARE PIN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | emacatuno37387@direct-srhs.et0939.epichosted.com | Direct |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090427000536 | SC | Practitioner - Pediatric Medicine | 1557419736 | Reassigns benefits to 4 organizations |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M23575 | SC | MD | Pediatric Adolescent Medicine Physician |
| 23575 | SC | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Cherokee Medical Center | Current | Accepting new patients | |
| Cherokee Medical Center | Current | Accepting new patients | |
| Union Medical Center | Current | Accepting new patients | |
| Union Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Current | Accepting new patients | |
| Union Medical Center | Current | Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients | |
| Spartanburg Medical Center | Past | Accepting new patients |
Locations
103 Stuard St
Gaffney, SC 29341
Phone (864) 488-9500
840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300
101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915
853 N Church St
Ste 401
Spartanburg, SC 29303
Phone (864) 560-6287
101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554
853 N Church St
Ste 410A
Spartanburg, SC 29303
Phone (864) 560-6928
1201 Furman L Fendley Hwy
Ste B
Union, SC 29379
Phone (864) 429-8846
Interoperability endpoints
- emacatuno37387@direct-srhs.et0939.epichosted.com
Organizations & group practices 13
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.
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SC
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-
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-
- Family Medicine Physician
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-
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- NPI 1942188875
-
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- Union, SC
- NPI 1811499890
-
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- Union, SC
- NPI 1841074044
-
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- NPI 1376580852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612396800000",
"number": "1649219585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 743070",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303743070",
"telephone_number": "864-560-4304",
"fax_number": "864-560-4413"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 E WOOD ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293033040",
"telephone_number": "864-560-6287",
"fax_number": "864-560-7091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACATUNO",
"first_name": "EDIFEL",
"middle_name": "N",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2021-02-04",
"certification_date": "2021-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "SC",
"license": "M23575",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "SC",
"license": "23575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SCC5085019",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SCC508H895",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "235757",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PIN",
"identifier": "SCC508J577",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "emacatuno37387@direct-srhs.et0939.epichosted.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "emacatuno37387@direct-srhs.et0939.epichosted.com",
"address_1": "101 E Wood St",
"city": "Spartanburg",
"state": "SC",
"country_code": "US",
"postal_code": "293033040",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.