Individual provider Active NPI

Edifel N Macatuno, M.D.

  • Pediatric Adolescent Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1649219585
Registry record updated Feb 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
23575 Issued in SC
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

Updated by the provider on Feb 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
SCC5085019OtherSCMEDICARE PIN
SCC508H895OtherSCMEDICARE PIN
235757MedicaidSC
SCC508J577OtherSCMEDICARE PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
M23575SCMDPediatric Adolescent Medicine Physician
23575SCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince May 1, 2018 Accepting new patients
Spartanburg Medical Center CurrentSince May 1, 2018 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Cherokee Medical Center CurrentSince Jun 2, 2020 Accepting new patients
Cherokee Medical Center CurrentSince Jun 2, 2020 Accepting new patients
Union Medical Center CurrentSince Mar 1, 2018 Accepting new patients
Union Medical Center CurrentSince Mar 1, 2018 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Jun 1, 2018 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

  • Direct secure messaging: 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.

View all 13

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

Verify at the official NPI Registry.