Individual provider Active NPI

Sushil Kumar Das, M.D.

  • Internal Medicine Physician
  • Rock Hill, SC
National Provider Identifier
1659353811
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
18689 Issued in SC
Practice address
1787 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone
(803) 324-7777
Fax
(803) 324-8787
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 18689 SC Primary

Addresses

Primary practice location

1787 Ebenezer Rd
Rock Hill, SC 29732-1101

Mailing address

1410 Snyder St
Rock Hill, SC 29732-7721
Phone (803) 324-7777

Other identifiers 1

IdentifierTypeStateIssuer
T27986MedicaidSC

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
I20050517000353 SC Practitioner - Internal Medicine 4981645231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1787 Ebenezer Rd
Rock Hill, SC 29732-1101
Phone (803) 324-7777

Hospital & facility affiliations

  • Interim Healthcare of the Triad Inc. Home health agency, Charlotte, NC, CCN 347234
  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue413

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18689SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Medical Association, P.a. Internal Medicine CurrentSince Jul 1, 2000 Accepting new patients
Lewisville Medical Center Incorporated Internal Medicine Past Accepting new patients
Lewisville Medical Center, Inc. Past Accepting new patients

Locations

1787 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 324-7777

Organizations & group practices 3

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 2

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1659353811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 SNYDER ST",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297327721",
            "telephone_number": "803-324-7777",
            "fax_number": "803-324-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1787 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321101",
            "telephone_number": "803-324-7777",
            "fax_number": "803-324-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAS",
        "first_name": "SUSHIL",
        "middle_name": "KUMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "18689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T27986",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.