Mamikon Gukasov, D.O

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

39233 Issued in SC

Practice address

171 Ashley Ave
Charleston, SC 29425-8905

Phone

(843) 792-1414

NPI assigned

May 13, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Anesthesiology

Education

Michigan State University College of Osteopathic Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Wren Anesthesia Services LLCGroup PAC ID 4183153976, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health East Cooper Medical Center Hospital, Mount Pleasant, SC, CCN 420089

Merit-based Incentive Payment System (MIPS)

Final score

79.02 of 100Reported as group

Quality

62.41

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Carolina Wren Anesthesia Services, LLC

  • Anesthesiology Physician
  • Mount Pleasant, SC
  • NPI 1184445694
  Medicare reassignment Care Compare group NPD
• Atlantic Coast Anesthesia Services P.C.

  • Anesthesiology Physician
  • Myrtle Beach, SC
  • NPI 1932641313
  Medicare reassignment NPD
• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• University Medical Associates of the Medical University of South Carol

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• University Medical Associates of the Medical University of South Carol

  • Anesthesiology Physician
  • Charleston, SC
  • NPI 1104843713
  NPD
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496

  Anesthesiology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• East Cooper Medical Center LLC

  • General Acute Care Hospital
  • Mount Pleasant, SC
  • NPI 1841069044
  Care Compare affiliation

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1679929103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUKASOV",
        "first_name": "MAMIKON",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-13",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "39233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Angel Lagtapon Guevara, MD
• Orin F Guidry, MD
• Constance Guille, MD
• Marcelo Silveira Guimaraes, MD
• Courtney Guinyard
• Sergey Gukasov, M.D.
• Robert E Gulbranson
• George Joseph Guldan III, MD
• Christine Gum
• Jessica A Gum, LMSW

• Anesthesiology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.