Individual provider Active NPI

Edward G Behrens, M.D.

  • Otolaryngology Physician
  • Charleston, SC
National Provider Identifier
1669479986
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
20222 Issued in SC
Practice address
1849 Savage Rd
Charleston, SC 29407-4726
Phone
(843) 766-7103
NPI assigned
Jul 1, 2005
Reactivated
Mar 27, 2006
Last updated
Oct 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 20222 SC Primary

Addresses

Primary practice location

1849 Savage Rd
Charleston, SC 29407-4726

Mailing address

1849 Savage Rd
Charleston, SC 29407-4726
Phone (843) 766-7103

Other identifiers 1

IdentifierTypeStateIssuer
202220MedicaidSC

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
I20050202000687 SC Practitioner - Otolaryngology 3476504945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Oklahoma College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston ENT Associates, LLCGroup PAC ID 4082662234, 77 clinicians

Practice addresses (Care Compare)

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.33 of 100Reported as group
Quality
86.06
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20222SCMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston ENT Associates, LLC CurrentSince Feb 1, 2005 Accepting new patients
Charleston ENT Associates, LLC Otolaryngology CurrentSince Feb 1, 2005 Accepting new patients

Locations

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

2295 Henry Tecklenburg Dr
Charleston, SC 29414

Interoperability endpoints

  • Direct secure messaging: edward.behrens.p1@direct.entap.nextgenshare.com

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, 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": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1669479986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1849 SAVAGE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "843-766-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1849 SAVAGE RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074726",
            "telephone_number": "843-766-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "EDWARD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2007-10-09",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "20222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202220",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.