Individual provider Active NPI

Carleton Argo Mentzer III, PA-C

  • Physician Assistant
  • Bluffton, SC
National Provider Identifier
1679540587
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1652 Issued in SC
Practice address
64 Bluffton Rd
Bluffton, SC 29910-7621
Phone
(843) 757-0676
Fax
(843) 757-0779
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200003 LA
Physician Assistant 363A00000X 1652 SC Primary

Addresses

Primary practice location

64 Bluffton Rd
Bluffton, SC 29910-7621

Mailing address

PO Box 749306
Atlanta, GA 30374-9306
Phone (843) 757-0676

Other identifiers 1

IdentifierTypeStateIssuer
1380PAMedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414001957 SC Practitioner - Physician Assistant 9931124971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.200003LAMDPhysician Assistant
200003LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Foucher Emergency Physicians Physician Assistant Past Accepting new patients
Chair MRI of Louisiana LLC Past Accepting new patients
Louisiana Em-1 Medical Services, PA Physician Assistant Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1679540587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306",
            "telephone_number": "843-757-0676",
            "fax_number": "843-757-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BLUFFTON RD",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299107621",
            "telephone_number": "843-757-0676",
            "fax_number": "843-757-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENTZER",
        "first_name": "CARLETON",
        "middle_name": "ARGO",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200003",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "1652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1380PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.