NPIMap

Individual provider Active NPI

Trenton Pace Dittmer, M.D.

  • Diagnostic Radiology Physician
  • Atlanta, GA
National Provider Identifier
1750639894
Registry record updated May 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
88225 Issued in GA
Practice address
1365A Clifton Rd NE Ste at-627
Atlanta, GA 30322-8905
Phone
(404) 778-4446
NPI assigned
Aug 21, 2012
Last updated
May 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 39436 SC
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X 88225 GA Primary

Addresses

Primary practice location

1365A Clifton Rd NE Ste at-627
Atlanta, GA 30322-8905

Mailing address

1365A Clifton Rd NE Ste at-627
Atlanta, GA 30322-8905
Phone (404) 778-4446

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital, MSC 333
Charleston, SC 29425-8905
Phone (843) 792-7179

Other practice location 2

1210 W Faris Rd
Greenville, SC 29605-4444
Phone (864) 522-1800

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
I20220516000970 SC Practitioner - Diagnostic Radiology 1153697248 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Mercer University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health University Medical GroupGroup PAC ID 8325950983, shared by 5 NPIs, 2,467 clinicians

Practice addresses (Care Compare)

1210 W Faris Rd
Greenville, SC 29605-4444
Phone (864) 522-1800

1519 Marion St
Columbia, SC 29201-2910
Phone (803) 296-5954

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39436SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 31, 2022 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 29, 2024 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Feb 9, 2026 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Aug 8, 2025 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jul 30, 2024 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jan 31, 2022 Accepting new patients
Prisma Health University Medical Group Diagnostic Radiology CurrentSince Jul 17, 2022 Accepting new patients
Prisma Health Imaging Centers, LLC CurrentSince Jan 26, 2026 Accepting new patients

Locations

1519 Marion St
Columbia, SC 29201
Phone (803) 296-5513

1210 W Faris Rd
Greenville, SC 29605
Phone (864) 295-4410

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Organizations & group practices 8

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 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1750639894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1365A CLIFTON RD NE STE AT-627",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303228905",
            "telephone_number": "404-778-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365A CLIFTON RD NE STE AT-627",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303228905",
            "telephone_number": "404-778-4446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital, MSC 333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-792-7179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 W Faris Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054444",
            "country_code": "US",
            "telephone_number": "864-522-1800",
            "fax_number": "864-522-1806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DITTMER",
        "first_name": "TRENTON",
        "middle_name": "PACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "39436",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "88225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.