NPIMap

Individual provider Active NPI

Nicolas James Mazal, M.D.

  • Diagnostic Radiology Physician
  • Mount Pleasant, SC
National Provider Identifier
1659637569
Registry record updated Jan 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
40730 Issued in SC
Practice address
1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone
(843) 824-0606
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 29073 OK
Diagnostic Radiology Physician 2085R0202X 40730 SC Primary

Addresses

Primary practice location

1241 Woodland Ave
Mt Pleasant, SC 29464-3288

Mailing address

1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone (843) 824-0606

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
I20180807002617 SC Practitioner - Diagnostic Radiology 4486920477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pelican II LLCGroup PAC ID 1759484082, 18 clinicians
Charleston Radiologists PAGroup PAC ID 9436054715, 35 clinicians

Practice addresses (Care Compare)

1241 Woodland Ave
Mt Pleasant, SC 29464-3288
Phone (843) 881-4020

2550 Elms Ctr Rd
North Charleston, SC 29406-9844
Phone (866) 717-9687

295 Midland Pkwy
Summerville, SC 29485-8104
Phone (866) 717-9687

501 Robertson Blvd
Walterboro, SC 29488-2787
Phone (866) 717-9687

8330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (866) 717-9687

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.62 of 100Reported as group
Quality
79.55
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29073OKMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Radiologists PA Diagnostic Radiology CurrentSince Jul 6, 2018 Accepting new patients
Pelican II, LLC Diagnostic Radiology CurrentSince Jul 17, 2018 Accepting new patients

Locations

1241 Woodland Ave
Mt Pleasant, SC 29464
Phone (843) 881-4020

Organizations & group practices 2

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 9

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547596800000",
    "number": "1659637569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 WOODLAND AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643288",
            "telephone_number": "843-824-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 WOODLAND AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643288",
            "telephone_number": "843-824-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZAL",
        "first_name": "NICOLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2019-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "29073",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "40730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.