NPIMap

Individual provider Active NPI

Idris Sayed Sharaf, M.D.

  • Cardiovascular Disease Physician
  • Aiken, SC
National Provider Identifier
1659454098
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
20264 Issued in SC
Practice address
137 Miracle Dr
Aiken, SC 29801-6351
Phone
(803) 641-4874
Fax
(803) 641-0436
NPI assigned
Oct 21, 2006
Last updated
Mar 11, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 20264 SC Primary

Addresses

Primary practice location

137 Miracle Dr
Aiken, SC 29801-6351

Mailing address

367 S. Gulph Rd
Att: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (803) 641-4874

Other identifiers 1

IdentifierTypeStateIssuer
202649MedicaidSC

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
I20110329000747 SC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2860675006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Medical College of Georgia School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

137 Miracle Dr
Aiken, SC 29801-6351
Phone (803) 226-0589

420 Society Hill Dr
Aiken, SC 29803-1731

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Regional Medical Centers LLC CurrentSince Jul 1, 1999 Accepting new patients
Aiken Professional Association LLC Cardiovascular Disease CurrentSince Oct 13, 2014 Accepting new patients
Aiken Regional Medical Centers LLC CurrentSince Jul 1, 1999 Accepting new patients
Aiken Professional Association, LLC Cardiovascular Disease CurrentSince Oct 13, 2014 Accepting new patients
Southside Dermatology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

367 S Gulph Rd
Kng of Prussa, PA 19406
Phone (610) 382-4422

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

440 Society Hill Dr
Ste 202
Aiken, SC 29803
Phone (803) 226-0102

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1659454098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "803-641-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MIRACLE DR",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016351",
            "telephone_number": "803-641-4874",
            "fax_number": "803-641-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARAF",
        "first_name": "IDRIS",
        "middle_name": "SAYED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "20264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202649",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.